Partnership Relations Contact Report Form

Partnership Relations Contact Report Form

Select Organization Type*

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Community Agency*

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Municipality *

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Name of New Organization*

Zip Code*

Date of Engagement*

Organization Contact Name*

First and Last - List all participants if applicable

Phone

Email

Purpose of Engagement*

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Other Purpose of Engament

Contact Detail*

Next Steps*

Please share any action items you identified with the partner

Comments

Feel free to share any additional comments and/or opportunities for interdepartmental collaboration

File Upload - Optional

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Staff Name*

Send me a copy of my responses

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