Add or Update Your Organization in the 211 Database

Company

This field is for validation purposes and should be left unchanged.

211 Agency Information

Thank you for being part of the 211 system! 211 connects thousands of people each year with the resources and services they need. Please complete this form to ensure we have the most accurate and up-to-date information about your agency, location and programs. Keeping your information current helps us connect callers with the right resources and can save your team time by reducing calls from people you may be unable to assist. If your agency has more than one location, please complete a separate form for each location. Please note: This form does not automatically collect your name or email address. Please provide your contact information below so we can follow up if needed.

Section 1: Agency Contact Information

Organization Name(Required)

Your Name(Required)

First Last

Your Email Address(Required)

Your Phone Number(Required)

Public Contact Email

This email address may be shared with 211 callers and used for client inquiries.

Public Contact Phone

This phone number may be shared with 211 callers and used for client inquiries.

Client Intake or Access Line

If different from the organization contact phone number above.

Section 2: Location Information

Does your organization have a physical location where clients can receive services?(Required)

Yes

Physical Address(Required)

Street Address Address Line 2 City State ZIP Code

Is the mailing address the same as the physical address?(Required)

Yes, my mailing and physical addresses are the same.

No, my mailing address is different from my physical address.

Mailing Address(Required)

Please enter your mailing address if it is different from the physical address provided above.

Street Address Address Line 2 City State ZIP Code

Hours of Operation(Required)

Please enter your regular hours of operation using this format: TIME, DAY-DAY (Example: 8:00 a.m. to 12:00 p.m., Mon-Thu)

Can clients visit this location?(Required)

Yes

If clients can visit your office, please provide travel instructions below.(Required)

Use landmarks if possible

Is an appointment required for clients to visit this location?(Required)

Yes

Is this location accessible by public transportation?(Required)

Yes

Unsure

If yes, please provide the route number(s)/name(s) and the closest stop(s) to your organization.(Required)

Section 3: Agency Information

Does your organization have a 501(c)(3) determination letter from the IRS identifying it as a charitable organization?(Required)

If yes, please email a copy of your 501(c)(3) determination letter to mfigueroa@unitedcv.org

Yes

Not applicable

Agency Type(Required)

Select all that apply.

Church-affiliated

Coalition/Other group

Private nonprofit

Public – City

Public – County

Public – Federal

Public – State

For-profit

Military installation

Section 4: Updates & Additional Information

Why are you submitting this form?(Required)

New organization: Add to the 211 system

Returning organization: Updating existing information

What information are you updating?(Required)

Select all that apply.

New organization (All)

Contact information

Mailing address

Physical address

Hours of operation

Agency type

Transportation/accessibility information

Program information

Other

Other:(Required)

Additional Information or Updates

Please provide any other changes or information you would like us to know.

Join the 211 Resource Database

211 Agency Information

Section 1: Agency Contact Information

Section 2: Location Information

Section 3: Agency Information

Section 4: Updates & Additional Information

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