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Third-Party Resource Application

Please review the information needed before beginning this application.

Information Needed:

Distinctions
Qualifications
Capabilities
Resume
Certifications

Other Information Needed:

How will CONNSTEP’s clients benefit from your services?
How can CONNSTEP’s account managers identify and qualify potential clients?
How do you price your services?
How can we create a win-win-win situation for the client, you, and CONNSTEP?

Apply to be a Third Party Resource

Please fill out the form below. If you are interested in learning more about serving as a third party resource for CONNSTEP, please contact us at info@connstep.org.
A. General/Contact Information
Company Name*
Name*

First NameLast Name
Job Title*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Website URL*
Distinctions*
Please provide any relevant and active memberships, certifications, languages, licenses, awards, and other notable distinctions.
Were you referred to CONNSTEP?*

YesNo
Referral Source to CONNSTEP
B. Organization Information
Is your organization a:*

Private CompanyCommunity College4-Year College or UniversityOther Education or Training OrganizationEconomic Development AgencyProfessional or Trade OrganizationOther (please specify)
Year Established*
Number of Employees*
Please indicate the type of insurance coverage you have:*

General LiabilityAutomobile InsuranceWorker's CompensationProfessional LiabilityDo Not Know
Please indicate the counties in which you are willing to work:*

FairfieldHartfordLitchfieldMiddlesexNew HavenNew LondonTollandWindham
Please select those that apply:*

Minority Business EnterprisePersons with Disability Business EnterpriseVeteran Owned Small BusinessWoman Business EnterpriseNoneOther
If other, please explain.
C. Qualifications
Please provide a descriptive summary of your expertise and capabilities.
- What do you do?
- How will CONNSTEP’s clients benefit from your services?
- How can CONNSTEP’s account managers identify and qualify potential clients?
- How do you price your services?
- How can we create a win-win-win situation for the client, you, and CONNSTEP?
Capabilities*
Have you worked with other MEP Centers? Please describe:*
Areas of Expertise:*

Workforce DevelopmentLeanQualityGrowth ServicesSustainabilityStrategicBusiness & FinancialEngineering & TechnologyInformation TechnologySix SigmaSafetyNew Product DevelopmentSupply Chain
List industries that you do not work with:*
Activity: Please indicate how many different clients you have served as a consultant in the past two years*
D. Resume

Please upload Resume below.
File Upload

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E. Recommendations

Recommendations from clients for which your organization has served as a consultant are helpful. Please upload Letters of Reference below.
File Upload

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F. Certifications
File Upload

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G. Additional Attachments

To help us present your credentials to clients most effectively, you are welcome to attach the additional materials. You may attach brochures & marketing materials, and samples of work.
File Upload

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350 Church St.
Hartford, CT 06103

info@connstep.org

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