1. Organization Profile

Organization Name: *

Organization Type: *

Website *

Head Quarters (Country) *

2. Point of Contact

Full Name *

Position *

Department: *

Company/Business Email *

Phone *

3. Partnership Scope

Partnership Scope *

4. Strategic Alignment (Why Partner?)

Strategic Alignment (Why Partner?) *

5. Partnership Interest Level

Partnership Interest Level *

6. Message / Specific Interest

Tell us about your goals:

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