AEP Partner Organization Application

Name of organization: *

Main Contact Name *

Main Contact Title: *

Main Contact Email: *

Organization Street Address: *

City: *

State: *

Zip Code: *

Organization Type: *

Organization Mission *

What is the national scope of the Organization's work? If the organization is local in scope, describe the organization’s efforts to implement program evaluation, data collection and analysis, and the use of evaluation in its work. *

In what ways do these activities reflect the AEP Statement of Shared Principles? *

How many individuals does the organization serve? *

How many organizations? *

Please describe your constituencies (educators, policymakers, students, etc): *

Organizational description for AEP Website (limit 150 Words): *

0/200 words

Education	Government
Cultural	Arts
Philanthropic	Business
Other Other