PENCIL recruits business partners for NYC public schools in the five boroughs throughout the year. We invite you to enroll your school to be matched with a partner.

General Information

School Type:	PS MS HS	Other:
School Number:
School Name:
Grades Served:
Principal Name:
Principal Email:
Years NYC public school principal:
Years as principal of current school:
School Address:
Phone:
Fax:
Borough:
Percent ELL:
Percent Free Lunch:
Ethnic Breakdown:

Alternate School Contact:

Name:
Title:
Email:

School Support Organization:

	Empowerment Network
	Partner Support Organization
	(please specify)
	Learning Support Organization
	(please specify)

Please check one of the following:

	I plan to continue working with my current partner:
	Partner's Name: Partner’s Company:
	I have confirmed my own match with a new individual.
	Partner’s Name: Partner’s Company: Partner’s Phone: Partner’s Email:
	I am participating for the first time or I am a returning principal who wants to begin a new partnership.

Only new schools or those requesting new partners are required to complete the sections below.

Please briefly outline your top three goals.

Does your school have a specific focus or special programs or are you interested in developing any new programs (e.g. law, art, music, media) that would be of interest to a potential partner?

Only new partners or returning partners requesting a new school are required to complete the sections below and to attach a personal biography and brief description of their company.

In which of the following areas would you be most interested in collaborating with a partner school? (Check all that apply)

	Career Awareness (exposure to careers in specific industries, job preparedness, internships)
	College Preparation (e.g. test preparation, college visits, financial aid guidance)
	Curriculum Enhancement
	Fundraising Guidance
	Leadership Development for rincipal and/or staff (team-building, budgeting, etc.)
	Parent Involvement
	School Identity (marketing/branding)
	Student Opportunities (e.g. after-school programming, incentive programs, innovative field trips)
	Technology

Other