Directory Submission Form

September 22, 2010

If you are an agency in Surrey, BC, and you would like to be included in the SurreyCares Directory and be added to our mailing/emailing list, please complete this form.

Organization Name *

Organization Description *

Who are you and what do you do? Aim for 30 words or less, please.

Service Categories (Check all that apply) *

Animals

Arts

Disabilities

Education

Fitness

Food

Health

Newcomers

Safety

Seniors

Shelter

Sports

Transportation

Youth

Other

If "Other," please list:

If you included "Other" in your Service Categories selections, please list "Other Services" that you provide, one service per line.

Mailing Address *

Physical Address *

Where do people go to talk to you in person?

Google Maps Link

A Google Maps link to your physical address would be really, really helpful, in most cases. For some, we "get it." No worries.

Website(s) *

Please include the full "http://" part at the beginning. If you have two web addresses, please place them on separate lines.

Email Address *

What is your main contact email address? e.g. info@myagency.com

Anything else we should know? *

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