Community Alliance Application | EEB Cleaning Services

1. ORGANIZATION INFORMATION

Organization / Business Name *

Organization Type *

Mission Statement / Purpose *

Years in Operation *

Tax Exempt / Non-Profit Status *

EIN (If applicable)

Website

Social Media (Optional)

Primary Contact Name *

Title / Position *

Email Address *

Phone Number *

Alternate Phone

Best Time to Contact

What type of support or resources are you hoping to gain?

Who do you serve? (Select all that apply) *

Children / Youth Families Seniors Low-Income Communities

At-Risk Populations Individuals with Disabilities Local Residents Other

Estimated number of people your organization serves annually

Describe your most impactful community initiative or achievement.