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Registration for Twogether Service Provider
NAME OF CURRICULUM*
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Authorization to Publish Information
Organization Name :
In addition to relaying information about your organization’s services over the telephone, 2-1-1 Texas and Twogether in Texas will disseminate information in printed directories and in an online database, which is available at www.211texas.org. Many social service professionals and volunteers at churches, nonprofit organizations, schools, and government agencies use this information to refer their clients to organizations and programs. Please feel free to call us if you have concerns related to this form.
This signed release form will be retained on file as an ongoing authorization that 2-1-1 Texas and Twogether in Texas may provide information to the public regarding the services of the above-named agency.
Name :
Title :
Date 3/15/2010
ENGLISH
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