CSBG Statement of Support

Yes! We add our names to the Community Action Statement of Support for CSBG!

By completing this form, your organization signs onto the Community Action Statement of Support for CSBG.

All fields must be completed for your organization's name to be added to the list.

Questions? Contact Denise Harlow, Partnership CEO, at dharlow@communityactionpartnership.com.

Thank you for your efforts to support full funding for the Community Services Block Grant!

Name *

Organization *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address of person authorized to add your organization as a supporter *

Phone Number of person authorized to add your organization as a supporter *

Yes

I don't know

Other (please specify)

Executive Director/CEO

Board Chair/Board President

Deputy Director

CSBG Director

Other (please specify)

Nonprofit/Private Community Action Agency

Public Community Action Agency (local city/county governmental agency, unit of local government)

Tribal Government

State Community Action Association

Regional Community Action Association

Local Partner Organization

Statewide Partner Organization

National Partner Organization

Other (please specify)