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Big Thought Institute
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programs
Learning Partners: Registration Form
Program registration
Organization Info
Organization Name
Organization Website
REQUIRED: Upload your organization's logo here (acceptable files and specifications: .jpg or .png; 300x300 px; file cannot exceed 5 MB)
Attachment
Primary Address Type
Please select...
Billing
Shipping
Street Address
City
State
Zip Code
In paragraph format, b
riefly describe the Organization's mission or vision
, give a brief description of what your organization does, who do you serve, and where do you serve (150 word limit):
Personal Info
First Name
Last Name
Preferred First Name
Your Title in the Organization
What is your organization’s Employer Identification Number (EIN)?
In the format XX-XXXXXXX
Preferred Phone Type
Please select...
Mobile
Work
Other
Preferred Phone Number
Secondary Phone Type
Please select...
Mobile
Work
Other
Secondary Phone Number
Preferred Email
Please select...
Personal
Work
Alternative
Email Address
Partner Classification Name (choose max. of 2)
Vendor: Offers services for sale unrelated to programming
Community Resource: Services open to the community for use and elected officials
Program Provider: Offers educational/enrichment service for youth
Venue/Facility: Site for events or programming
Target Population
(choose a max. of 3)
Early Childhood: Ages 3-5/Grade PreK-K
Elementary School: Ages 5-10/Grade 1-5
Middle School: Ages 11-13/Grade 6-8
High School: Ages 14-18/Grade 9-12
Post Secondary Learning: Age 17+/colleges, universities, trade, or vocational
SPED: All ages/Education accommodations for individual needs
Opportunity Youth: Age 16-24/Disconnected youth from school and work
Alternative Youth: All ages/Displaced from traditional schooling for disciplinary reasoning
Juvenile Justice: Age 10-17/Partially or fully adjudicated based on criminal charges
Adults: Age 24+/Removed from schooling with a focus on independent living
Communities Partner Serves
County (choose max. of 2)
Dallas
Collin
Tarrant
Denton
Other
All
County Section (choose max. of 4)
Northeast
Northwest
Southeast
Southwest
Dallas County Northeast Cities/Towns
Dallas County Northwest Cities/Towns
Dallas County Southeast Cities/Towns
Dallas County Southwest Cities/Towns
Collin County Northeast Cities/Towns
Collin County Northwest Cities/Towns
Collin County Southeast Cities/Towns
Collin County Southwest Cities/Towns
Tarrant County Northeast Cities/Towns
Tarrant County Northwest Cities/Towns
Tarrant County Southeast Cities/Towns
Tarrant County Southwest Cities/Towns
Denton County Northeast Cities/Towns
Denton County Northwest Cities/Towns
Denton County Southeast Cities/Towns
Denton County Southwest Cities/Towns
If Other, please input City and State
City and State
Enter as city, state abbreviation (e.g. Dallas, TX)
Partnership Focus
Partnership Focus Category
(choose max. of 2)
Sports and Wellness
Performing Arts
Visual Arts and Digital Media
Music
Academics and College Prep
STEM
Civics & Service
Community Resources
Other
If Other, please specify:
Partner Focus Subcategory (choose max. of 2 for each subcategory)
Sports and Wellness Subcategory
Sports
Yoga
Character Development
Physical Education
Performing Arts Subcategory
Theater
Dance
Spoken Word
Visual Arts and Digital Media Subcategory
Painting and Drawing
Ceramics
Welding
Design and Making
Digital Media
Music Subcategory
Choral
Instrumental
DJing
Recording/Engineering
Academics and College Prep Subcategory
Literacy and Poetry
Tutoring
Remediation
Financial Literacy
ESL and Language
Internships
ACT/SAT
STEM Subcategory
Science
Technology
Engineering
Math
Coding
Civics and Service Subcategory
Community Action
Leadership
People and Cultures
Activism
Community Resources Subcategory
Food Services
Transportation
Health
Legal Services
Housing
How are your programs presented? (
check all that apply
)
In Person
Hybrid
Virtual Synchronous
Virtual Asynchronous
OPTIONAL: Share additional information about your organization such as history, programming, student stories, news coverage, etc. (acceptable files .doc, .jpgs, .pdf, or online links/URLs )
Attachment
Is your organization M/WBE
(Minority/Women-owned Business Enterprises
) Certified?
Yes
No
If not, are you interested in
pursuing M/WBE Certification
for your organization?
Yes
No
How did you hear about becoming a Program Partner?
Please select...
Referred by Big Thought staff member
Friend or colleague
Dallas After School Partner
Dallas City of Learning website
Big Thought website
Saw Dallas City of Learning at an Event
Saw Big Thought at an Event
Social Media
Other
Referral Source Name