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AKT Network Partnership Intake Form
Your name
Organization, college or department
Your email (or point of contact)
Proposed partner or program name
Type of partner
Academic institution
Healthcare organization
Business or industry partner
UK college or department
Other
Brief description of the idea or opportunity
What's the goal or focus? What impact could this have?
Which focus area(s) best align with this opportunity?
Healthcare Access and Innovation
Education and Opportunities
Workforce and Economic Development
Land-grant and Community Engagement
What role could the network play?
Example: research partner, student pipeline opportunity, community outreach, shared resource, etc.
Are there existing relationships or past collaborations with UK?
Yes
No
Unsure
Any known contacts or champions at UK?
List names and contact info if known.