SAMPLE Referral Partner Agreement: Winter 2022

[SAMPLE] GEO Connects Referral Partner Agreement 2022

This is only a sample. A pdf version of this agreement will be emailed to you upon completion of the Referral Partner Registration Form.

Purpose of this Agreement

This agreement outlines the proposed opportunity for [organization name] to act as  a Referral Partner with GEO Nova Scotia, participating in the GEO Connects program.

This Agreement outlines the following:

  1. Overview of GEO Nova Scotia
  2. GEO Connects Program Description
  3. Eligibility Criteria
  4. Role & Responsibilities
  5. Data Collection and Sharing
  6. Publicity, Disclosure, and Branding
  7. Duration and Termination of this Agreement
  8. Contact Details


Referral Partners: Organizations who are in partnership with GEO Nova Scotia to support Participants to be online

Key Person: The individual at a Referral Partner who is the primary contact for GEO Nova Scotia is regards to the GEO Connects Program.

Referral Agents: Staff members at a Referral Partner who are authorized to submit referrals into the GEO Connects program

Digital Champions: Staff and/or volunteers at a Referral Partner who are able to provide some basic 1:1 support for Participants who need it

Participants: Individual who has been referred to the GEO Connects Program for support

Digital Inclusion Facilitators: GEO Nova Scotia team members who work with Referral Agents to deliver the GEO Connects program, and provide training and support to Digital Champions.

  1. Overview of GEO Nova Scotia

The “GEO Project” (Getting Everyone Online) began in 2020 as an immediate response to the Covid pandemic and the lack of home computers and internet connectivity among low-income households in Dartmouth North and became a province-wide pilot in 2021.

Through a growing network of partnerships and core funding from the provincial government, in 2022 GEO Nova Scotia became its own non-profit organization dedicated to digital inclusion, ensuring everyone has what they need to be online.

  1. GEO Connects Program Description

GEO Connects distributes home internet service and computer equipment (typically Chromebooks and accessories) to people across Nova Scotia who could not otherwise afford them. This is achieved through a network of “Referral Partners”, organizations who work directly with low-income Nova Scotians who may be experiencing digital exclusion.

More program details are available on the GEO Nova Scotia website here: GEO Connects program description

  1. Eligibility Criteria

Referral Partners are responsible for identifying Participants who would be good candidates for the GEO Connects program: specifically, people in Nova Scotia who are experiencing digital exclusion and significant financial difficulties.

GEO Nova Scotia asks for information about Participants, including some financial information, however this is not used to determine eligibility. It is used to help GEO Nova Scotia design better programs and to better understand the financial situations faced by low-income Nova Scotians who are experiencing digital exclusion.

  1. Role & Responsibilities

GEO Nova Scotia commits to:

  • Providing orientation and ongoing support to Referral Agents
  • Providing training and ongoing support to Digital Champions
  • Arranging for delivery of devices to Referral Partners
  • Arranging for delivery of internet service through our Internet service provider partners
  • Proving new device warranty access support for 12 months
  • Coordinating and conducting ongoing evaluation activities
  • Sharing evaluation results and learnings
  • Promoting our collective work
  • Communicating all relevant developments/changes and paperwork requirements  relating to the delivery of the program
  • Maintaining open communication with Referral Partners
  • Working together to create a dignified experience for Participants

Referral Partners commit to:

  • Identifying and registering a Key Person as a single point of contact for the GEO Connects program
  • Registering at least one Referral Agent for orientation
  • Registering at least one Digital Champion for training
  • Receive devices from GEO Nova Scotia and distribute them to Participants
  • Providing program Participants access to Digital Champion support
  • Keeping partner records updated related to their Key Person, Referral Agent(s), Digital Champion(s), and Participants
  • Participating in check-ins with Digital Inclusion Facilitators
  • Participating in evaluation activities, as able
  • Reporting any concerns or difficulties related to the experience of Participants
  • Maintaining open communication with Partners
  • Working together to create a dignified experience for Participants
  1. Data Collection and Sharing

GEO Nova Scotia collects information from Participants for the following purposes:

  • To improve service
  • To better understand who is receiving support (and who is not)
  • To better understand the status of Digital Inclusion among Nova Scotians (access to internet, devices, and basic digital skills)
  • To better understand the financial situations faced by low-income households in Nova Scotia who are experiencing digital exclusion

GEO Nova Scotia respects all relevant legislation related to the storage of personal information.

GEO Nova Scotia will not disclose personal or identifying information about Participants to anyone without their express written consent, unless compelled to by law.

  1. Publicity, Disclosure, and Branding

GEO Nova Scotia may publicly publish or otherwise identify Referral Partners by name and logo.

GEO Nova Scotia may disclose quantitative information related to its partnership with Referral Partners as needed for reporting, evaluation, and learning purposes. 

Referral Partners may publicly identify themselves as such and use GEO Nova Scotia logos to that effect, so long as this agreement is in effect.

  1. Duration and Termination of this Agreement

This Agreement shall commence on the date of signature below, and shall continue for 12 months unless terminated earlier by either party, and may continue beyond 12 months if both parties agree.

GEO Nova Scotia may terminate this Agreement by written notice to the Referral Partner if (a) the Referral Partner breaches any of the terms of this Agreement, and/or (b) funding for GEO Nova Scotia is suspended, terminated and/or revoked. If this Agreement is terminated by GEO Nova Scotia, the Referral Partner may be required to return to GEO Nova Scotia any Devices which have not yet been distributed to Participants.

Referral Partners may terminate this agreement by written notice for any reason.

In the event of a termination of this Agreement for any reason, parties agree to make all reasonable efforts to ensure a smooth transition for any existing Participants, as needed.

  1. Contact details

Matt Spurway, Executive Director, GEO Nova Scotia


Danielle Pentland, Director of Operations, GEO Nova Scotia


Acceptance of This Agreement

GEO Nova Scotia and the undersigned Referral Partner agree to the terms of this Agreement.

Name: ________________________________________

Position: ________________________________________

Signature: ________________________________________

Date:     ________________________________________