Community Information Database Org. Form

Organization Submission Form

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Thank you for your interest in the Pasadena Community Directory. To add or update your organization's listing, please use the form below.

We are interested in clubs, organizations, and human service agencies that serve the city of Pasadena. Decisions on content, format, and distribution are the responsibility of Pasadena Public Library staff, as outlined in our policies and procedures.

Required entries are marked with asterisks (***), but please enter all items if possible (and applicable). The information will be reviewed by Pasadena Community Information staff prior to appearing in the database. Please allow ten business days.

Do you consider yours a not-for-profit organization/program/ agency?***	Yes No Don't know
Organization/ program name***
Organization/program is also known as (if any)
Organization's/program's parent agency (if any)
Other official affiliations (if any)
Mailing address -- number & street***
City***
State***
Zip***
Main telephone # ***	Format: ###-###-####, x####
Toll-free #, hotline, or other phone	Format: ###-###-####, x####
Fax #	Format: ###-###-####, x####
TTY/TDD	Format: ###-###-####, x####
E-mail

Web address:

Director/CEO/other person in charge:

Title of person in charge:

Purpose of your organization/program (max 500 characters):***

How would you describe your main source of funding?

What is your annual budget?

$0 - $499,000 $500,000 - $999,999
$1,000,000 - $3,999,999 $4,000,000 and over

Who is your main target group for service (seniors, victims of abuse, etc.)?

Meeting time(s) and day(s) or office hours, etc.:

Meeting place and address:

OR same as mailing address

How to apply for services (walk-in, phone, etc.):

Requirements to be eligible for service:

Dues/fees/charges:***

Services offered in these languages:***

Access for people with disabilities:

Do you provide child care for the clientele using your services?

Yes
No

Many times the public is looking for volunteer opportunities. Does your Organization/Program welcome individual volunteers?
Yes
No

Does your Organization/Program provide volunteers as a service to other people, projects, agencies, etc?

Yes
No

Official publication(s) of your organization/program:

Do you offer visual arts exhibition space? (Record will say to call for details.)

Yes
No

Do you offer public meeting rooms? Yes No

Can they be used as performance venues? Yes No

The following will be used by staff only (not shown in public listing):

Contact person***
Contact e-mail

Comments

Printed copies of this form may be sent by mail to:
Pasadena Public Library - Community Directory
285 E. Walnut St.
Pasadena, CA. 91101

Or by fax to:
626-796-3818

Data processing made possible by MarcEdit.