Agency Profile

Agency Name:

Street Address:

City:

Zip Code:

Phone:

Website:

Mission Statement:

Primary Contact:

Primary Contact Position:

Primary Contact Phone:

Primary Contact Email:

Executive Director:

Are you are a registered 501(c)3? Select ... yes no pending Other

Please check all that apply to your past history with the Junior League of Lawton:

Placement (recurring volunteers)

Project (volunteers + funding)

Done-in-a-Day (one time volunteers)

Other

Please check all that apply to your intended status with the Junior League of Lawton:

Placement (long term volunteers)

Project (long term volunteers + funding)

Done-in-a-Day (one time volunteers)

JLL Diaper Bank Assistance

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