Intake Form - No Cost Partnership

 
 
 

This date must be at least 10 weeks from today date. You can access the board dates here

 
mm/dd/yyyy
 

Agreement Term is the date the services shall commence.

 
mm/dd/yyyy
 

Agreement Term is the date the services shall end on.

 
mm/dd/yyyy
 

Point of Contact if there are questions related to this intake form. It is important this information is complete and accurate.

 
 

Work email address (sandi.net)

 
Phone
 

Please use 4 digits.

 

This is the District employee that will supervise the services being performed.

 
 
 
 

Please include Address, City, State, and Zip.

 
 
Phone
 

This is the legal name of the company or person performing services and matched the W9 form.

 

Person signing the contract

 
 

Please include Address, City, State, and Zip.

 

Of the person signing the contract on behalf of the company

 
Phone
 

1. Scope of Work or Proposal

Drop your files here
 

(e.g.: WHAT from WHOM and for HOW LONG):

 
 
 

Choose your Area Superintendent, Director, or Chief.

 

This information is needed for the Board Agenda.