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Join LACFA

Community Based Organization

Thank you for your interest in joining LACFA. This form is designed to collect your general information and will take less than 3 minutes to complete.

Name *

First Name

Last Name

Position Title *

Email *

Phone *

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Organization Name *

Organization Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What area(s) does your organization serve? (i.e. San Fernando Valley) *

Which of the following areas are focuses of your organization? (check all that apply)

Child Welfare (foster care, etc.)

Criminal Justice Reform/Incarceration

Crisis Intervention (domestic violence, emergency care, goods distribution, etc.)

Education (schools, pre-schools, classes, awareness campaigns, etc.)

Homeless Services

Human Trafficking/Exploitation

Immigrant Services

Medical/Health Services (clinics, crisis pregnancy, etc.)

Mental Health (counseling, therapy, recovery, etc.)

Poverty Alleviation

Provide Space (for other programs/organizations)

Services (housing, rehab, legal aid, etc.)

In a couple of sentences, tell us what your organization does? *

Thank you!

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