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Are you an existing Partner?
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Organization Name

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What's your address?

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Contact Information for Representative #1
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Job Title

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What's your email?

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What's your phone number?

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*Contact Information for Representative #2
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Job Title

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What's your email?

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What's your phone number?

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Which Partner Level are you applying for?

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Describe your organization. Focus on the "Who, What, Where, When and How."
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Why do you want to partner with the National Council? (2-3 sentences suggested)
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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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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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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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How does partnership with the National Council fit into the larger vision of your organization?
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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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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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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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Please provide any additional information you would like to share that you haven't already.
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Type question here