LocalResourcesAssignmentTemplate.docx

Place a picture here that represents the agency.

Agency Name: Write the full name of the agency or organization here.

Population Served: Who does this agency work with? For example, it could be children, families, people struggling with addiction, people who have experienced domestic violence, people who are grieving, etc.

Programs Offered: How do they help clients? For example, do they provide case management, help with services like food stamps, job training, counseling, etc. Many services have a program name (like “Targeted Case Management” or “Adult Day Training”), so include the names of each program and what the program does.

Mission Statement: Look on the website and write their mission here.

Who Qualifies for Services: What do people need to be eligible for help? For example, do they need a documented learning disability, to make under a certain amount of money, to live in a certain county, etc.

Website: Write the agency’s website here.

Address: Write the agency’s address here.

Phone Number: Write the agency’s phone number here.

Contact Person: Who should a Human Services Professional contact if they have questions about services? The website might have this information, or you may need to call and ask. Once you find out, write the contact person’s name and contact information here.