MATTER Innovation Hub Application

MATTER Innovation Hub Application

Please complete all questions to the best of your ability.
School/ Organization Making The Request
1. Agency's Full Name:
2. Website:
3. Date of Program Establishment:

Month Day Year
Date
NGO Verification (please check only one)
NGO Verification:

This agency is a 501(C)3 organization that is not a privately funded foundation or municipality (please upload a copy of your 501(C)3 letter below). This agency does not have a NGO.
Upload NGO Verification 501(C)3 letter here:

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Contact Information

In-Country Program Information
1. Primary Site Name (if different from Organization Name):
2. Please indicate education provided (Please check all that apply).:

Primary School Secondary School Job skills training Technical School
3. Student body percentage:
Girls
Student body percentage:
Boys
4. Site Address (or final destination where the MATTER Innovation Hub will be delivered):
5. Have you shipped a container to a school before? If so, please describe how you cleared customs:
6. Enrollment:

Primary School Enrollment Secondary School Enrollment Other School Enrollment Total School Enrollment
7. Please describe how MATTER's Innovation Hub will be used to serve the student population:

8. Please indicate percentage of funding for your program (complete all that apply):

9. Please list other agencies from whom you receive support (materials & resources, not funding- use additional sheet if necessary):
10. Please indicate services offered at the school (Please check all that apply).

School Laboratory Computer Lab School Feeding Program
Other Information
1. How did you hear about the MATTER Innovation Hub?
2. Please provide a narrative outline of your program (attach separate sheet if more space is needed). Include any relevant information you may wish to share to help us determine whether a partnership with your organization would be a good fit with MATTER:
If you have any questions please contact:

Jeremy Newhouse

Jeremy@matter.ngo
7005 Oxford Street, St. Louis Park, MN 55426 | 952-500-8652| matter.ngo
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In-Country Program Information