REGISTRATION FORM

Social Workers and other representatives of certified nonprofit organizations are eligible to receive items from Community Giving Tree for their clients.

To register to receive donations, please provide the following information about you and the agency you represent. We will review your registration and contact you with additional information about joining our distribution list and picking up items.

* = Required

Your Name:*

Agency Name:*

Office Location:*

Cities/Towns Served:*

Number of Clients You're Currently Serving:*

Your Email Address:*

Your Phone Number:*

Alternate Phone Number:

Any Comments:

2+2=?  * Required to prevent spam

| Share