AGENCY INFORMATIONCommunity and Health ServicesAgency Name *Agency's Address *Apartment / SuiteCity *State/Province *ZIP / Postal Code *Agency's Phone *Agency's FaxAgency's Email *Agency WebsitePlease check all types of services & programs your agency provides: *Clothes & GoodsFamily SupportChildren & Youth ServicesFinancial SupportLegal ServicesHousing & UtilitiesFoodParental ServicesEmployment ServicesChild CareElderly CareTransportationCounselingWellness & Health CareEducationCONTACT INFORMATIONPrimary Point PersionFirst Name *Last Name *Mobile PhoneOffice Phone *Email AddressEVENT INFORMATIONRequest Area PlacementLocation *Waupaca - Thursday August 6, 2020Delta County - Sunday August 30, 2020Area / Category *Community ServicesHealth ServicesJob ServicesSPECIAL REQUESTSWill you need electricity? *YesNoOne (1) Table and Two (2) Chairs Offered.Explain if you have any special reqeuss related to teh provision of additional space, tables, or chairsYou are our Guest of Honor. We wil provide your organization: Cold Water 1 Six Foot table & 2 Chairs Lunch Parking Statement of Participation (if needed for community service hours) Comments, Notes, Questions:AUTHORIZATIONAuthorized Signature *Today's Date *Signator's Position *Signator's Email *Final Details: Your organization will be asked to forward a Certificate of Liability documentation; Waupaca will be at the Rec Center. Delta County at The U.P. State Fairgrounds; We hope to foster susainable relationships between guests and volunteers with your organizatoin. Therefore our expectation is your booth would have at least one (1) representative present at all times; Mission of HOPE is not responsibly for any lost or dmaaged items; Mission of HOPE reserves teh right to remove any material deemeded unsuitable to the eent's mission and purpose; We anticipate servingi more than 80+ volunteers seeking opportuniteis to link with local organizatoins this year; We anticipate serving more than 350 Guests in Waupaca and more than 2,000 Guests in Escanaba seeking opportuniteis to link with your programs this year; Space is limited. First come. First served. Due to budget considerations, resource allocations, and volunteer placement, please complete nad complete this form as soon as possible. Questions may be directed to [email protected] :: (800) 725-5276GDPR *Yes, I agree with the Privacy Policy and Terms & Conditions. Send Message