PLEASE ONLY COMPLETE IF A REPRESENTATIVE(S) FROM YOUR ORGANIZATION HAS ATTENDED AT LEAST 3 MEETINGS. This form verifies that your organization/agency has had representation at no less than three Children's Council meetings in the past twelve months and agrees to become a member agency with voting rights. To maintain agency voting status, there must be representatives from your agency who, collectively, attend a minimum of three meetings in a twelve month period.
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Organization Name:
Organization Program(s)- if applicable
Description (brief description about service provided)
Website (the link to the specific program/service, if possible)
Mailing Address:
Phone Number (the number that clients will use to apply/access the service)
Are there topics of interest or information you would like to learn more about or share at a Children's Council meeting? (optional)
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