KYOSA STEM Coalition Partner Form

Hello and welcome! You are invited to become a partner in the Kentucky Out-of-School Alliance's Science, Technology, Engineering & Math (STEM) Initiatives. STEM Partners are defined as resources and service providers, advocates, and all interested parties invested in promoting statewide STEM learning opportunities.

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* 1. STEM Partners may be actively involved in several ways. Tell us how you would like to be involved (please check all that apply):

Curriculum Specialist

Data Collection

Researcher

Business Advisor

Distribution of Information

Trainer

Direct Program Implementation

Special Populations Advisor

Other (please specify)

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* 2. Please provide your partner information below:

Partner Contact (Name & Title):

Organization Name:

Phone:

Email:

Mailing Address:

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* 1. STEM Partners may be actively involved in several ways. Tell us how you would like to be involved (please check all that apply):

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* 2. Please provide your partner information below:

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* 3. Please provide a brief description of your organization below: