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HSC | Membership Application
To apply for membership in the Human Service Chamber of Franklin County, please complete and submit the form below!
If you have any questions, please email Executive Director, Michael Corey, at
mcorey@humanservicechamber.org
.
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* Indicates required question
Email
*
Your answer
Agency Name
*
Your answer
Agency Revenue (During the last calendar or fiscal year)
*
Your answer
Number of Agency Employees
*
Your answer
Agency Website URL
*
Your answer
Select all the categories that accurately describe the kinds of health and human services work your agency does:
*
Advocacy
Arts
Community Building
Developmental Disabilities
Family Safety
Food and Nutrition (Educational Programming)
Food and Nutrition (Food Pantry Operator)
Food and Nutrition (Food Programs)
Health (Addiction Services)
Health (Behavioral Health Provider)
Health (Healthcare Provider)
Housing (Affordable Housing)
Housing (Homelessness)
Legal Services
Nonprofit Supports
Reentry Services
Referral Services
Refugee & Immigration Services
Senior Services
Veteran Services
Volunteer Services
Workforce Development
Youth & Education (Child Care or Early Education)
Youth & Education (In-School or Afterschool Program)
Youth & Education (Mentoring)
Youth & Education (Secondary School)
Required
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