Offer Your Expertise

Thank you for your interest in providing services to YouthQuest!  We value our partnerships with organizations in the community as we work together to impact our youth for a better tomorrow.

Instructions

• Complete the form below – or –
• Click here to download the application (Word | PDF)
  • Please complete the downloaded application and submit by one of the following options:
    – Email: awatts@flintandgenesee.org
    – Fax: 810.600.1463
    – Mail: YouthQuest, Attention:  Amy Watts, 519 S. Saginaw Street, Suite 200, Flint, MI 48502

*Note: Electronic application with the Word document is preferred. Please do a “save as” including your organization name in the document title.

Mission and Objectives

YouthQuest is a free, innovative, after school enrichment program for youth, grades K-12, in Genesee County, Michigan, managed by the Flint & Genesee Chamber of Commerce (FGCC).  Currently, we are located in several schools in Carman-Ainsworth, Flint, and International Academy.  YouthQuest is made possible through the generous support of the Charles Stewart Mott Foundation, along with additional funders and donations.

The mission of YouthQuest is to provide youth with engaging after school experiences to excel, excite, and explore! The program typically operates three hours per day, Monday – Thursday, typically between 2:30-7 PM.

We are looking for vendors (persons or organizations that provide a paid service at any YouthQuest site) who will help us to accomplish this mission by aligning safe, engaging and exciting learning experiences with our core program objectives:

• Academic Support
• Enrichment Activities
• Physical Fitness and Healthy Behaviors
• Nutrition and Nutrition Education
• Youth Development/Leadership
• Family & Community Engagement

Required Documentation: Approved as a Prospective Vendor

ALL vendors and their staff working with children in YouthQuest are required to do one of the following:

Non-Profit Organizations

• Provide a copy of the background check(s) or provide a written statement on the organization’s letterhead confirming that the employee(s) have fulfilled this requirement.

Independent Contractors

• Obtain Central Registry Clearance at the Department of Human Services (DHS) office.  You will need a picture identification (there is no charge) AND
• Provide the YouthQuest office with a date of birth for all staff that would work as part of the vendor program so an i-Chat background check may be secured by our office

Previously approved vendors must annually provide a letter stating that the status of all representatives is unchanged from the original background check. (New staff must still complete the background check.) It will be the responsibility of the vendor to report to YouthQuest any change in status of one of its representative and/or withdraw said individual(s) from providing services through their corporation or organization to YouthQuest.

All vendors must provide an EIN number OR all employees who work with the YouthQuest program will be asked to submit a copy of their driver’s license (front and back) and a social security number.  These will be kept in secure files at the FGCC.

Additionally, all corporate and non-profit vendors who provide services at a YouthQuest site must supply a copy of their certificate of liability coverage showing the Genesee Area Focus Fund (the support organization of the GRCC’s YouthQuest program) as an “additional insured party” at $500,000 or more.

If you are human, leave this field blank.

Vendor Application and Proposal

Organization Name or Individual Vendor Name *

Date of Application *

Are you a member of the Flint & Genesee Chamber of Commerce?

Yes

No

This is a(n): *

Business

Non-profit Organization

Individual / Independent Contractor

Organization Primary Contact:

First Name: *

Last Name: *

Address *

Apt, suite, etc.

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City

StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces (AA)Armed Forces (AE)Armed Forces (AP)American SamoaGuamNorthern Mariana IslandsPuerto RicoUS Minor Outlying IslandsUS Virgin Islands

Zip code

Primary Phone # (include area code): *

Secondary Phone #

Email

Website

EIN (organizations)

Three references of those who have used your services:

Include organization, contact name, and phone number

1 - Organization *

Contact Person *

Phone (include area code) *

2 - Organization *

Contact Person *

Phone (include area code) *

3 - Organization *

Contact Person *

Phone (include area code) *

Proposed Program Description

1. Title of Your Program *

2. Please briefly describe what your program entails and how it will meet the above core objective(s): *

3. Materials Needed: *

Will you provide materials or will YouthQuest be responsible to purchase them? *

I am providing materials

YouthQuest be responsible to purchase them

N/A

Cost:

4. Activity Details (Please indicate how many students you can work with at a time, how long a session would be, how many sessions you propose, what age group, etc.): *

5. Proposed Rate (This will be negotiated. Indicate proposed rate per hour / session or per student.): *

6. People Providing Program (1. List all staff from your organization that will be providing program to YouthQuest.): *

7. Other (Any other information you’d like us to know?):

Submit

YouthQuest is a free after school initiative operated by the Flint & Genesee Chamber of Commerce through the generous support of the Charles Stewart Mott Foundation and others.