Thank you for your interest in partnering with Houston ISD! This application will help us get a clear picture of your interest in partnering with HISD, your organizational structure, programming and funding models. Your completed application will be reviewed and evaluated within 7 days of receipt. Potential partners will be contacted regarding next steps, if approved. If you have questions or comments, please feel free to contact us at partner@houstonisd.org.
IMPORTANT
Please Note: this form can be saved at any time. You MUST confirm submission after reviewing your answers on the last page or your form will not be received.
Screening Questions
I have reviewed the HISD Partnership Guidelines and consent to continue (
Partnership Guidelines
)
I Consent
Have you reviewed the requirements for onboarding as outlined in the
Community Partnerships orientation
?
Yes
No
Are there fees associated with your service/programming?
Yes
No
Are you currently going through the vendor process?
Yes
No
Unsure
Are you a mental health provider?
Yes
No
Are you a medical service provider?
Yes
No
How long have you been in business?
What client base do you serve?
What funding source do you use to see clients?
Are you on an insurance board?
Yes
No
Unsure
Do you offer pro-bono services?
Yes
No
Depends
How many clinicians work with you?
What is your capacity for clients to be seen?
What is your assessment process?
What is the minimum number of students that need to be signed up before receiving services?
Contact Information and Program Overview
Organization Name:
Primary Contact First Name:
Primary Contact Last Name
Primary Contact Email Address:
Phone Number
Executive Director/CEO Name:
Executive Director/CEO Email Address:
Company Street Address
City
State
Zip Code
Tax ID Number:
Organization Type:
Please select...
Nonprofit agency/Community based organization
Corporation
Faith institution
College/University
State Government Agency
Federal Government Agency
City of Houston
Parent Organization
Alumni Group
Fraternity/Sorority
Other
Briefly describe your organization's mission.
Select services that apply to your organization
Mental Health
Basic Needs
Out of School Time/Extended Learning Opportunities
Legal, Safety, and/or Crisis Support
Cultural/Arts
Social and Recreational
Other
Other
If you have been working with someone from the District on this project or if you were referred by someone, please give us their name and department.
Funding Model
Does your organization receive federal funds?
Yes
No
Yes, but not in the proposed partnership
How is the programming for this proposed partnership funded?
What is the duration of this funding?
1 semester
1 year
More than a year
Funding is still pending
What is the estimated value of your services?
Under $3,000
$3,000-$5,000
$5,000 and above
Partnership Proposal
Provide a brief description of the proposed partnership.
This partnership will be:
A one-time event
An ongoing program
An annual event
Unknown
I would like my partnership to impact the following areas:
STEM
Literacy
Fine Arts
Social Studies
Character Education
Career Readiness/Technical Education
Health
Mental Health
Athletics
College Readiness
Community/Family Support
I am interested in partnering to provide the following activities:
Academic support/tutoring
Mentoring
Workshops
In-kind resources/Incentives
Basic need support
Mental Health support
Pro Bono Legal
Social emotional learning support
Technology
Training
Field trips
Donations
Out of School time
Internships/Practicuum
Describe your program activities (i.e. # of sessions, # of workshops).
List up to three short term outcomes expected from the program.
List up to three long term outcomes expected from the program.
Target Population
Is your program limited to a zip code, area, or school?
Yes
No
If yes, please list the zip codes, areas, or schools.
Who is your targeted audience?
Students
Parents/Caregivers
Community
Campus Leadership (Principals, Assistant Principals, Deans, Counselors)
Campus Support Staff (Facilities, Administrative Support, Nurse)
Teachers
District Staff
District Leadership
District Support Staff (Transportation, Nutrition Services, Library Services, Wraparound Specialists, Health & Medical Wellness)
Does your program specifically target English Language Learners?
Yes
No
What is the maximum number of clients you are able to serve, based on either funding or staff/student ratios?
What type of school are you interested in targeting?
Early Childhood Center
Elementary School
Middle School
High School
RISE School
A specific geographic area
A feeder pattern
How many schools are you interested in partnering with?
Is there a specific school you'd like to work with?
What specific grades would you like to target?
Please select...
ECC
K
1
2
3
4
5
6
7
8
9
10
11
12
Proposed start date for the program.
Proposed end date for the program.
Where does your programming take place?
On-site (flexibly space on campus)
On-site (need a consistent space on campus)
Off-site (non HISD location)
Both on- and off-site
Virtual
Both on-site and virtual
Other
Other
Additional Information
Do you want to request a data sharing agreement?
Yes
No
Maybe
What do you need in place for your program to be successful?
Can you provide proof of adequate insurance?
Yes
No
Submit the name and contact information for two references (recipients, partners).
Upload your program logic model or program plan.
Upload your program budget (include any committed funding sources).
Upload any supporting documents you would like here.