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APPLICATION REVISION FORM INSTRUCTIONS:
Fill-in the blanks for what needs to be replaced on your home page.
If you are adding something to what already exists write (add) beside it.
If you need something deleted print out your current home page and clearly mark what
sections or words need to be deleted and submit with this form.
Knoxlink.org
c/o United Way of Knox County
110 East High Street
Mount Vernon, OH 43050

Organization Name:         Date:  
Contact Name:         Title:  
Should this person's name be listed on your page?        Yes         or         No
Mailing Address:  
Physical Address:  
City:          State:       Zip:  
Primary Phone:       Primary Fax:  
Email (this will be listed on your page):  
Web link:  
Please name and give brief descriptions for each volunteer opportunity at your agency. You may want to note seasonal opportunities vs. ongoing opportunities:
Vol. Opp 1:  
Vol. Opp 2:  
Vol. Opp 3:  
Vol. Opp 4:  
Vol. Opp 5:  
Vol. Opp 6:  
# Paid Full-Time Staff:        # Paid Part-Time Staff  
Hours of Operation:  
Agency Status (501(c)(3),etc.):  
Year Organized:  
Handicap Accessibility Details:  
General Parking Details:  
Other Names, Nicknames, etc. for your Organization:  
Overall Agency Description (2-3 sentences):
Please list programs that you provide with a short description of each program by name (max. of 10 programs). Words listed in this section, as well as on this entire form become key words that people can use in a general word search. Make sure that you incorporate any words or program names that people will reference in a search (e.g. food stamps, Metro, WIC, etc.).
Program name - description:
1.  
2.  
3.  
4.  
5.  
6.  
7.  
8.  
9.  
10.
We wish to have a photo on our page:        Yes         or         No
        If yes, please indicate how you will send that photo to United Way:
                Electronic upon request
                 Will mail hard copy for United Way to scan upon notification of acceptance
We wish to have our logo on our page:       Yes         or         No
        If yes, please indicate how you will send that logo to United Way:
                Electronic upon request
                Will mail hard copy for United Way to scan upon notification of acceptance
Your agency page will appear under the following categories that you select
(choose the top categories that best fit your agency):
Clothing Legal Assistance
Crisis Intervention Parent Education
Early Care and Education Recreation & Hobbies
Education (K-Adult) Religious & Spiritual Support
Employment Senior Support
Financial Assistance Support Groups
Food Transportation
Health & Wellness Youth Programs
Housing/Shelter  

or

© Copyright 2004-2005 Knox County Family and Children First Council.
Call United Way at 740 397-5721 for more information
Created and maintained by ECR.