We are excited to partner with you!! Please take a moment to complete the following questionnaire to help us better prepare to serve your youth.

School Or Organization Name *

School or Organization Address *

Name of Point Of Contact *

POC Email Address *

POC Phone Number *

Dates Requested for Workshops/Speaker *

Time allotted for workshops/speaker *

Number of Students *

Please provide the number of students for each program of interest. *

Are there specific areas of opportunity you would like us to address with the students? *

Which program(s) are you interested in as a Mentor? *

I Am Royalty (girls ages 8-12)

Crown Her (teen girls/young adults 13-21)

I Am King (boys ages 8-13) (young adults 13-21)

Student Challenges *

Is there any student specific information you would like to share with us? *

Is there any additional information or context you would like to provide? *

Is an MOU (Memorandum of Understanding) required for this partnership?

Would You Like To Stay In Touch? *

Yes

How Did You Hear About Us? *

Thank you for your interest in partnering with Crowned for Purpose. We look forward to the opportunity to work with your students and contribute to their personal and academic development.

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.