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Two in One Collaboration Interest Form
Please respond with your interest and capacity to officially partner with us by August 1, 2022
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* Indicates required question
Name
*
Your answer
Organization/Institution Name
*
Your answer
Preferred Email
*
Your answer
Name of Authorized Contact Person
*
Your answer
Preferred Email for Authorized Contact Person
*
Your answer
Please indicate which of the following activities you are interested in participating (Check all that apply).
*
Disseminate announcements on the training series to listservs, social media, newsletters.
Help secure speakers for the training series and policy summit.
Help secure actors for the social marketing messages.
Have us speak at one of your events or meetings.
Connect us with pipeline programs at your institutions.
Share your logo on our program website and promotional materials.
Consent to publish name and affiliation on our website (
twoinone.smhs.gwu.edu
).
Required
Does your institution/org require a Memorandum of Agreement (MOA) for this collaboration?
*
Yes
No
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