elderjusticeny.org · Web viewDescribe your organization’s mission, and how bringing CELJ’s...
2
MOBILE LEGAL UNIT APPLICATION Name: _______________________________________________________ Organization: _______________________________________________________ Address: _______________________________________________________ Email: _______________________________________________________ Phone: _______________________________________________________ Address where mobile legal unit event will be held (if different than above): _______________________________________________________ Type of organization (e.g. non-profit organization, nutrition site, local OFA, etc.)? _______________________________________________________ Describe your organization’s mission, and how bringing CELJ’s mobile legal unit to your site furthers that mission (300 word max): _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ ______________________ Approximately how many seniors does your organization serve on a weekly basis? _______________ Please complete this form and e-mail it to [email protected] . Thank you!
Transcript of elderjusticeny.org · Web viewDescribe your organization’s mission, and how bringing CELJ’s...
MOBILE LEGAL UNIT APPLICATIONName: _______________________________________________________Organization: _______________________________________________________Address: _______________________________________________________Email: _______________________________________________________Phone: _______________________________________________________Address where mobile legal unit event will be held (if different than above): _______________________________________________________Type of organization (e.g. non-profit organization, nutrition site, local OFA, etc.)? _______________________________________________________Describe your organization’s mission, and how bringing CELJ’s mobile legal unit to your site furthers that mission (300 word max):____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Approximately how many seniors does your organization serve on a weekly basis? _______________Mark which day(s) of the week and time frame would you like to host the mobile legal unit:
Monday Tuesday Wednesday Thursday FridayMorning (9 a.m.-12 p.m.)Lunch (11 a.m.-2 p.m.)Afternoon (1 p.m.-4 p.m.)
Please complete this form and e-mail it to [email protected] . Thank you!
Do you have wireless internet access? _____Yes _____ NoIf we provide a flyer, would you be able to advertise (e.g. using social media, local newspaper, website, etc.)? _____Yes _____ No If yes, briefly explain: _______________________________________________________How did you hear about us?
_______________________________________________________
Please complete this form and e-mail it to [email protected] . Thank you!
