Contact STEAM Imagine | Non-profit STEM organization

Name*

First Last

Address

Street Address City State ZIP Code

Email*

Enter Email Confirm Email

Phone*

Communication Preference*

Email
Phone
Text

I AM A...*

Please answer the following in regards to your child.

Gender*

Male
Female

Birthdate*

Race*

The following apply:

Allergies
Disability
Foster Care

Describe Allergies

Describe Disability

Parent Name*

First Last

Parent Phone*

Parent Email*

Enter Email Confirm Email

I am interested in the following YES programs:*

Youth Apprenticeship
Career & Education Counseling
Empowerment Training
Life Skills & Wellness Development

Where do you teach?*

High School
Community College
College or University
Vocational Training School

Is your business willing to host a youth apprentice for YES?*

Yes
No

What is the name of your business?*

Business Address*

Street Address City State ZIP Code

My business is*

An Employer Company with Employees
Single Owner Entrepreneur

Are you willing to submit a business profile?*

Yes
No

I represent a*

Local Government Department
State Government Department
Federal Government Department

Name of government entity*

Name of non-profit organization*

Purpose of your non-profit organization*

Name of contract company*

Name of point of contact for contract company*

Are you interested in doing contract business with YES, LLC with regards to:*

Federal Contract Opportunity
State Contract Opportunity
Local Contract Opportunity
Corporate Business to Business Opportunity

Contract vehicle:*

Please specify*

Are you willing to provide a capability statement?*

Yes
No

I am interested in participating in the following YES programs:*

Youth Apprenticeship
Career & Education Counseling
Empowerment Training
Life Skills & Wellness Development

Are you willing to submit a resume or bio with references?*

Yes
No

Are you willing to an organizational profile of your non-profit?*

Yes
No

Are you willing to get a background check?*

Yes
No

Please describe your subject matter expertise or experience to contribute to YES programs.*

Are you willing to volunteer to conduct a monthly workshop/training to youth on your expertise?*

Yes
No

What is your apprentice occupation for the youth?*

What type of apprenticeship are you offering?*

Paid
Unpaid

Does your business have liability insurance for employees?*

Yes
No

Additional Details

Contact Us

Contact Information

Email Address