L.A. SHARES - Become a Recipient
ORGANIZATIONAL PROFILE
Name of Organization
Director/CEO of Organization
Address 1
Address 2
Floor/Suite
City
State
Zip
L.A. City Council District
(Where your headquarters are located.)

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WHO WILL BE THE CONTACT PERSON FOR THIS PROGRAM?
First Name
Last Name
Phone

Your organization or school's work number only. No cell phones or personal telephone numbers allowed.
E-mail

Your E-mail address will be used as your login when returning to the site.
Password

Please enter a Password between 5 to 8 characters. No spaces or quotes.
       
SERVICE FIELD - Check the one that best describes your organization
Aging Economic Development Human Services
Alcohol / Drug Recovery Education International Affairs
Animal - Related Employment Public Affairs / Policy
Arts Environment Public Safety
Civil Rights / Social Action Food / Nutrition Recreation / Sports
Community Improvement Health - General Religion - Related
Crime - Legal Related Health - Mental Science / Technology
Cultural / Humanities Homeless Volunteerism
Disabled Housing / Shelter Youth Development
 
TARGET POPULATION - Check all that apply
Children (0-5) Male Caucasian
Children (6-12) Female African American
Youth (13-18) Gay / Lesbian Hispanic
Young Adult (19-25)   Asian / Pacific Islander
Adult (26-64)   Native American Indian / Alaskan Native
Senior (65+)    
 
TELL US ABOUT YOUR ORGANIZATION
Annual Budget
Number of People
Served Annually

Staff Size
Submit
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