Collaborating Consultant Application

Umemba Health is seeking qualified and passionate subcontractors to join our network of collaborating consultants dedicated to transforming public health through comprehensive workforce development, strategic consulting, and tailored training solutions. If you are a professional or organization with expertise in public health, training, consulting, or related fields, we invite you to apply. This application process helps us ensure that subcontractors align with our mission, vision, and commitment to health equity.

Please complete all fields in the application. Attach supporting documents where requested.

Full Name *

Organization *

Address

Street Address *

City

State

Country

Postal code

Phone *

Linked to Website/Porfolio/LinkedIn *

Email *

If "other" above, please describe below:

Years of Consulting Experience in Relevant Fields *

Degress/Certification/Licenses Held: *

NAICS Codes (if applicable): *

Business Certifications (if applicable): *

Are you currently registered in Sam.Gov? *

Yes

No

Do You Have Experience Working with Federal or Government Agencies? *

Yes

No

If "yes" above, please provide more details below:

Describe Your Expertise and How It Aligns with Umemba Health’s Mission: *

List Past Projects/Contracts Relevant to Public Health or Workforce Development: *

Are You Comfortable Working Under Confidentiality Agreements? (NDA) *

Yes

No

Can You Provide References Upon Request? *

Yes

No

ATTACH THE FOLLOWING DOCUMENT(S): Resume/CV (for individuals) or Company Profile (for organizations) *

You may upload up to 2 files

ATTACH THE FOLLOWING DOCUMENT(S): Portfolio or Work Samples *

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to (XXX) XXX-XXXX for assistance. You can reply STOP to unsubscribe at any time.

By submitting this application, I certify that the information provided is accurate and complete to the best of my knowledge. I understand that submission of this application does not guarantee subcontractor approval.

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