| Your Name:
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| Your Phone:
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| Your E-mail:
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| Your relationship to UUCA (e.g. Member, Pledging friend, etc.):
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| * Suggested non-profit recipient:
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| Is the agency a 501(c)(3) organization?
Yes
No |
How would you categorize this non-profit agency?:
(select all that apply)
Aging
Animals
Arts & Entertainment
Digital Divide
Education
Environment
Food and Shelter
Health
Legal
Other
If OTHER, please describe:
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| Agency's website:
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| If we have questions or want to work with the agency in providing information at UUCA, who should we contact? |
| Contact Name:
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| Contact Phone:
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| Contact E-mail:
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| In what ways does this organization/group reflect and promote our UU principles and values? (250 word max) |
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| Does the agency have a need for monetary and in-kind donations? |
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| Are there ongoing ways in which individual UUCA members and friends might be involved with this group? (volunteering,
citizen advocacy, donations of supplies or equipment, etc). (250 word max) |
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| Is the agency headquartered locally or have a local office? |
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| Comments: |
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