Official Partnership Application

Name (first)

Name (last)

Job Title

Company

Street Address

City

State

Zip/Post Code

Phone

/ -

Fax

/ -

e-mail

Type of Organization (select one)

Government Agency Non-Governmental Organization

If NGO Please select

Privately Held Publicly Held

Year Founded:

Number of Employees

under 10		10-99		100-499
500-999		1000-9999		10,000 +

Product(s) Overview/Description:

Industries that utilize the products:

Company's target market:

Company's revenue for the past 3 years: Year 1 $ Year 2 $ Year 3 $

List your competitor's name and products:

What differentiates your product from your competition:

Does your company have a formal alliance with any other 501(c)3 ? Yes No

If yes, please list:

What is the general scope or value proposition you bring to the partnership? (please be specific)

I certify that the information contained in this application is correct to the best of my knowledge, and I agree to indemnify and hold harmless the Environmental Education Foundation, the Board, and those affiliated with the Foundation and its programs. I understand that the Environmental Education Foundation reserves the right to revise renewal requirements.