Partners Program Application

For Lower School Students

Parents/Guardians,

If you identify your lower school student from a historically marginalized group, underrepresented population, or a student of color (see the definition we use below), please complete this application form by September 6, 2023.

If you have any questions about the program, please contact Akira Townes ’13, Director of DEI.

Person/People of Color — NAIS (National Association of Independent Schools) considers ‘People of Color’ as individuals who are permanent residents or U.S. citizens and belong to one of the following racial/ethnic groups:  African American, Latino/Hispanic American, Asian American/South Asian, Native American, Middle Eastern American, Multiracial American, and Pacific Islander.

2023 – 24 Partners Program Application Form

"*" indicates required fields

Participated in the Partners Program last year?

I would like to keep my pairing from last year

Please complete the top section only if you want to keep your pairing from last year.

Parent/Guardian Name*

First Last

Student Name*

First Last

Our family will attend the Partners Kickoff Event on September 23, 2023.*

Yes

Number of Adults Attending September 23*

Number of Children Attending September 23*

Parent/Guardian Information

Parent/Guardian Name*

First Last

Parent/Guardian Email Address*

Primary Phone Number*

Secondary Phone Number

I prefer to receive information by*

US Mail

Phone

Student Information

Student Name*

First Last

Student Grade Level*

Please enter a number less than or equal to 12.

My child is identified racially as… (see NAIS definition above)*

Partner Preferences (select one)*

Comments

Please list five words that best describe your child.*

What are your child’s interests?*

Please list the activities your child is involved in both in and out of school.

My child would respond best to a student who is…*

Health concerns

Please list any other concerns.

For Parents

Are there issues of diversity that you would like the Partners Program to address with Lower, Middle, or Upper School students? If so, please describe.

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