Partner Site Application Form

Partner Site Application

Thank you for your interest in becoming a partner site. Please complete the application below to help us learn more about your organization and the opportunity you would like to offer. Submission of this application does not guarantee approval. A member of our team will review your information and contact you regarding next steps.

Organization Information

Organization Name

Organization Website

Organization Type (select all that apply)

Organization Address

Primary Contact

Primary Contact Name

Job Title

Email

Phone

Site Supervisor Name (If different from Primary Contact)

Site Supervisor Job Title (if different from primary contact)

Site Supervisor Email (if different from Primary Contact)

Site Supervisor Phone (if different from Primary Contact)

About Your Organization

Briefly describe your organization, its mission, and the communities you serve.

How long has your organization been operating?

What populations do you primarily serve?

Partnership Interest

Why are you interested in partnering with our program?

How did you hear about us?

What are you hoping to gain from this partnership?

Opportunity Information

What is the title of the role or opportunity you are hoping to create?

Briefly describe the purpose of this role.

What would the primary responsibilities include?

What skills or qualifications would help someone succeed in this role?

Approximately how many hours per week would this role require?

Where would this opportunity primarily take place?

On-Site

Hybrid

Remote

Preferred schedule

Background Checks and Additional Requirements

CORE covers the cost of the required TrueScreen background screening for all program members and site supervisors. This screening includes:

FBI Criminal History Check (with fingerprinting)
State Criminal Background Check
National Sex Offender Registry Check

If your organization requires any additional screenings, certifications, training, or other prerequisites beyond the CORE-required TrueScreen screening, your organization is responsible for communicating those requirements and any associated costs.

Are there any background checks, certifications, safety requirements, or other prerequisites that participants should be aware of before placement?

Examples may include organization-specific background checks, required certifications, immunizations, CPR/First Aid, confidentiality agreements, safety training, or dress code requirements.

Organization Support

Which of the following does your organization provide? (Select all that apply.)

Orientation or onboarding

Designated supervisor

Regular supervision/check-ins

Safe and professional work environment

Written policies and procedures

Professional development opportunities

Workspace or equipment (if applicable)

Additional Information & Agreement

Is there anything else you would like us to know?

Agreement

I certify that the information provided is accurate and complete.

I understand that submission of this application does not guarantee approval as a partner site.

I authorize my organization to be contacted regarding this application.

Signature

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