Our Directory - Add Your Agency | Beaver County Collaborative Action Network

Agency Directory Listing

Agency registration with BCCAN

Organization Name * Required
Alternate Name / Acronym
Parent Organization
Vision, Mission and/or Purpose of Organization
History of Organization
Accreditations and Licenses
Affiliations
Legal Structure
Funding Sources
Leadership
Key Leader(s)
Name* Title/Description (Executive Director, Vice President, etc.) Phone Number 1 Phone Number 2 Fax Number Email Address
Contact Person(s)
Name* Title/Description (Intake Specialist, Secretary, etc.) Phone Number 1 Phone Number 2 Fax Number Email Address
Contact Number(s)
Number* Title / Description (Telephone, Toll free, Fax, etc.)
E-mail(s)
Email* Title / Description (Director, General, Intake, etc.)
Web Addresses
Website* Title / Description (National, Local office, etc.)
Primary Address
Title/Description (Corporate office, Headquarters, etc.)
Address
Street Address Address Line 2 City State ZIP Code
Additional Addresses
Title/Description (Branch office, Satellite office, etc.) Address Line 1 Address Line 2 Address Line 3 City State Zip Code
Service Area (5 county tri-state area, statewide, etc.)
Services Provided - Service Areas
Service Description
Available Hours
Fees/Cost for Services
Eligibility Requirements
Required Documentation
How to Access Services or Schedule Appointments
Handicap Accessibility
Languages Spoken or Available
Speaker Available
- Yes
- No
- Unknown
Volunteer Use
- Yes
- No
- Unknown
Volunteer Need
- Yes
- No
- Unknown
Volunteer Description
Agency Logo
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Allowed types: jpg, gif, png - Maximum Size: 1MB
Maximum file size - 1 mega bytes.
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Our Directory – Add Your Agency

Agency Directory Listing

Leadership

Primary Address

Services Provided - Service Areas

Thank You To Our Sponsors

Name*	Title/Description (Executive Director, Vice President, etc.)	Phone Number 1	Phone Number 2	Fax Number	Email Address

Name*	Title/Description (Intake Specialist, Secretary, etc.)	Phone Number 1	Phone Number 2	Fax Number	Email Address

Number*	Title / Description (Telephone, Toll free, Fax, etc.)

Title/Description (Branch office, Satellite office, etc.)	Address Line 1	Address Line 2	Address Line 3	City	State	Zip Code

Email*	Title / Description (Director, General, Intake, etc.)