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Community Outreach – Application
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1
Organization Info
2
Contact Info
3
List of Items
Organization Info
If you are a child care center, children hospital, church, elementary school, or any organization that provides services to children in poverty or poor areas, please complete the following application and enroll in ALMS Community Outreach program. Once enrolled, ALMS will try to locate the items that you requested. When the items are obtained, ALMS will arrange donation to your organization.
Name of Organization
*
Organization Website / URL
*
Organization Address
*
Address Line 1
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Type of Organization
*
Child Care Center
Children Hospital
Church
Elementary School
Other
Other Organization
Please specify the type of your organization
Briefly Explain the Type of Child Services that your Organization Offers
*
Next
Contact Info
Contact Name
*
First
Last
Phone
*
Email
*
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List of Items that your Organization Needs to Support Children in Poverty
*
Please include item description and quantity. Please limit to children toys, clothing, & story books, elementary school stationary & supplies.
Certification
*
I certify that the information submitted is true and correct to the best of my knowledge
I further understand that any false information may result in denial or revocation of the application
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Email
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