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2.
Organization Name
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3.
What's your address?
*Address(1):
*Address(2):
*City:
*Zip:
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4.
Contact Information for Representative #1
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5.
Job Title
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6.
What's your email?
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7.
What's your phone number?
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8.
*Contact Information for Representative #2
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9.
Job Title
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10.
What's your email?
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11.
What's your phone number?
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12.
Which Partner Level are you applying for?
Bronze
Silver
Gold
Platinum
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13.
Describe your organization. Focus on the "Who, What, Where, When and How."
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14.
Why do you want to partner with the National Council? (2-3 sentences suggested)
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15.
What are the most important goals or objectives for your partnership with the National Council? (Please feel free to use bullet points)
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16.
In your words, how would our members benefit from the National Council's partnership with your organization? (2-3 sentences suggested)
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17.
What are your current annual sales for the products/services that are directed toward the mental health and addictions field (if applicable)?
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18.
How does partnership with the National Council fit into the larger vision of your organization?
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19.
What are your expectations of the National Council as a Partner? What do you think we can do very well? Where do you think we can help you? (4-5 sentences suggested)
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20.
What resources do you anticipate devoting to this partnership? What expectations do you have of the National Council? (2-3 sentences suggested)
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21.
Are there any must have's or nice-to-have's that have not been raised thus far? Are there any "no-go" areas for your organization?
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22.
Please provide any additional information you would like to share that you haven't already.