Resource Advisory Board

All submitted information will be verified before uploading it onto the Good News Herald web page.

Contact Information

Organization Name:

Purpose of Organization:

Contact Name:

Address:

City, State, Zip:

Cell Phone:

Work Phone:

Fax:

E-Mail Address:

WebSite URL:

Services Provided

What type of Services does your organization provide?

About Your Organization

Tell us briefly about what your organization is about and what kind of organization it is. Example: 501 C3, Faith Based Organization

Please Enter Staff Names and Positions

Staff1 Name

Title/Responsibilities

Staff2 Name

Title/Responsibilities

Staff3 Name

Title/Responsibilities

Staff3 Name

Title/Responsibilities

Please Enter Any Organizational Successes

Please Enter Any Organizational Needs

Optional Information Part I

Funding Source

Individuals %

Grants %

Endowments %

Other %

Total

Budget

Salaries %

Operational Expenses %

Services Provided %

Other %

Total

Optional Information Part II

Who's on your Board of Directors

President

Vice President

Treasurer

Secretary

Other

References

1.

2.

3.

Agreement and Signature

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if our organization and or individuals are accepted, any false statements, omissions, or other misrepresentations made by our organization and or individuals on this application may result in your immediate removal from the web page.

Name:

Please Type your Initials as a means of a digital signature.

Signature

Date

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