Simple Satellite Partner Agreement

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Date Completed(Required)

Crossing Location Partnership(Required)

Anderson

Elkhart County ETC

Fort Wayne

Frankfort

Gaylor/Noblesville

Hammond

Indianapolis

Lafayette

Muncie

About Your Business

Business Legal Name(Required)

DBA Name (If applicable)

Business Address(Required)

Street Address Address Line 2 City State ZIP Code

Business Phone Number

Main Contact Name(Required)

First Last

Main Contact Phone(Required)

Main Contact Email Address(Required)

Email Address Confirm Email Address

By checking the boxes below, the person named above agrees with the statements and requirements below.(Required)

The business will appoint an employee with the proper experience and credentials to directly oversee students. Business will submit employee experience and credential documentation to the Crossing

The Business will collaborate with Crossing staff regarding work responsibilities, attendance, concerns, etc.

The Crossing will be liable for all non-paid students, thus the Business will be added as an additional insured to Crossing liability insurance.

The Business will be responsible for liability on all PAID students through their liability and workers comp insurance (This applies to all SEAL and Earn & Learn programs).

The business will use discretion when placing students to ensure they are not near or with employees who have a criminal history that could potentially endanger students, such as sexual crimes, weapons charges, domestic violence or violence against children, drug trafficking, etc. This is not an exhaustive list, but provides examples of the risks to be diligent to avoid.

The Business will allow time for the Crossing to train the designated employee(s) on program supervision and curricular requirements.

Logo Upload

Please upload the logo you would like to be used in marketing materials where we recognize our business partnerships.

Drop files here or

Max. file size: 1 GB, Max. files: 4.

Signature

Type Business Representative Name HERE(Required)

I am signing this agreement as a legal representative of the business named above and understand this is a legal representation of my signature.