Step #1: Organizational Information Sheet
Email address
Our organization is applying as:
Membership Dues:
$100.00 if agency annual revenue exceeds $250,000, $50.00 if revenue is below $250,000.

Make all checks payable to: LA Regional Food Bank - ENLA Account

Mailing Address:
Emergency Network Los Angeles
Attn: Nathan Wolfstein
19040 Vanowen Street,
Reseda, CA 91335

Annual Revenue:
Amount Enclosed: ($)
Your answer
General Information
Legal Name of Organization/Business:
Your answer
Address:
Your answer
Website:
Your answer
Phone:
Your answer
Fax:
Your answer
ENLA Liaisons
Name of Executive Director/Senior Clergy:
Your answer
Primary Liaison to ENLA:
Your answer
Liaison Phone:
Your answer
Liaison E-mail:
Your answer
Liaison Fax:
Your answer
Secondary Contact:
Your answer
Secondary Phone:
Your answer
Coverage Areas
We are located in Disaster Management Area (DMA)
Required
Services Provided/Available
Select 3 of the below service classes
Service classes corresponding to your agency
Required
ENLA Committees
Select the below committees you (and your agency) are interested in joining
Committee groups to join
Is your organization interested in hosting an upcoming meeting?
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