Agency Form

10.22.19

Take the Step - Agency Participation Form
Due by Friday, October 4, 2019

* Indicates required field

Agency/Organization/Congregation *

Line 1

Line 2

City

State

Zip Code

Country

TTS Liaison Name *

First

Last

Email *

Cell Number *

Office Number *

Mission *

Who you serve, including eligibility requirements. *

BARRIERS ADDRESSED BY YOUR ORGANIZATION DURING AND AFTER THE EVENT

SERVICES PROVIDED BY YOUR ORGANIZATION DURING THE EVENT

Examples: Assessments of literacy, job-skills, career aptitude, health, etc., resume' preparation, mock interviews, assistance with forms/applications.

What services WILL you provide during the event? *

Will you be able to schedule follow-up appointments during the event? *

Yes No

Would you like to conduct the event intake and assessment at your agency prior to the event? *

Yes No

What, if any, information or documents will participants need in order for you to serve them at the event? *

Will you need volunteers during the event? *

Yes No

PREPARING FOR THE EVENT

Setup will take place on Tuesday, October 22, from 8:30 AM to 9:30 AM
Sign in and Orientation: All agency staff and volunteers will Sign In and participate in Orientation at 9:30 am.
Doors open: Doors will be opened to participants at 10 AM and will close at 2 PM.
Breakdown will take place from 2:00 to 3:00 PM.

How many tables will you need? *

How many chairs will you need? *

How many tablecloths will you need? *

Will you need access to electricity? *

We will provide t-shirts to each staff member and volunteer who actively participates at the event. We will contact you at a date closer to the event to get t-shirt size requirements.

T-shirts: How many staff members will you have over the course of the day? *

EVENT AGENCY DIRECTORY

Brief description of agency and services to be included in the Agency Directory. *

ETHNN will provide marketing materials, website listing and links, tables, chairs, a name board, access to electricity and Wi-Fi, a hospitality room, and t-shirts for agency staff and volunteers.

Upload your logo *

Max file size: 20MB

COMMITMENT due by Friday, October 4
By submitting this Agency Information Form, we are committing to participating in the Take the Step - A job skills event.
Sometimes things happen outside of our control, if we are unable to participate, we will contact Susan Walden at 903.216.3211 as soon as possible.

Commitment and submission made by: *

Submit

Take the Step - Agency Participation FormDue by Friday, October 4, 2019

Take the Step - Agency Participation Form
Due by Friday, October 4, 2019