Power of Connectivity

Organization Information

Primary Contact Name *

Organization Website (optional)

City of Organization

State of Organization

Communication Preference *

Call

Text

Partnership Alignment

Which best describes your organization? *

Nonprofit / Community Organization

Foundation / Philanthropic Fund

Corporate Sponsor / For-Profit Partner

Faith-Based or Educational Institution

Other (please specify)

If you selected Other:

How would you like to participate in the Power of Connectivity Campaign?

Funding / Sponsorship

Hosting or Supporting Local Activations

Promoting the Campaign to My Network

Providing Internet Access or Tech Support

Collecting Stories / Data for Impact Reporting

Other

(select all that apply)

If you selected Other:

Which region or state(s) are you primarily serving or representing? *

Baltimore, MD

Washington, DC

Northern Virginia, VA

Arlington

Alexandria

Falls Church

Indiana

Fort Wayne

Indianapolis

Evansville

South Bend

Arizona

Phoenix

Mesa

Tucson

Scottsdale

Alabama

Birmingham

Montgomery

Mobile

Huntsville

California

San Diego

San Francisco

Sacramento

San Jose

Nevada

North Las Vegas

Reno

Henderson

Carson City

Colorado

Denver

Colorado Springs

Aurora

Fort Collins

Texas

Austin

Dallas

Houston

San Antonio

Utah

Provo

Ogden

St. George

Salt Lake City

North Carolina

Charlotte

Raleigh

Greensboro

Durham

New Jersey

Trenton

Newark

Jersey City

Camden

Georgia

Atlanta

Macon

Savannah

Augusta

Ohio

Toledo

Columbus

Cleveland

Dayton

Tennessee

Nashville

Memphis

Knoxville

Chattanooga

Washington, WA

Seattle

Spokane

Tacoma

Olympia

Florida

Miami

Orlando

Tampa

Jacksonville

Illinois, IL

Chicago

Naperville

Peoria

Springfield

Community & Impact Focus

Which populations or communities does your organization primarily serve? *

How many people or households does your organization reach annually? *

Under 500

500–2,000

2,000–10,000

10,000+

Partnership Goals & Needs

What would make this partnership most valuable to your organization? *

Do you need outreach materials or media assets to promote the campaign? *

Yes - please send materials

Not right now

How soon would you like to begin participating? *

Immediately

Within 30 days

In 2026 rollout

Would you like to be listed as an official “Power of Connectivity Partner”? *

Yes, include our name in campaign materials

No, please keep our participation internal for now

Upload your organization logo (optional)

Any additional notes or questions for the DEG1 / Laila’s Love team?