InterAgency Council of Glen Cove, Ltd.
P.O. Box 532,
Glen Cove. NY 11542
516-365-8455 (Tel/Fax)
info@iacglencove.org
www.iacglencove.org

The primary mission of the InterAgency Council is to enhance the delivery of human services through collaboration and communication and to provide mutual support among community agencies through sharing and networking.

Membership Application

Agency Name:

Address:

City/ZIP:

Telephones, Fax:

Email, Website:

Primary contact person
Name, Title:

Second contact person
Name, Title:

Services provided (Comprehensive information will assist visitors to our website to find your services.):

 

Population Served:  □Adults  □Children  □Families  □All Ages  □All Genders  □Other:

Fees:

More Information:

 

Please return application to :

Arlene O'Dell, Membership Chair,
Glen Cove Youth Bureau
30A Glen St.
Glen Cove. NY 11542
516-671-4600
Fax 516-676-7749

InterAgency Council of Glen Cove. Lid is a 501(c)3 organization. As such, IAC is forbidden from engaging in political activity in support of or in opposition to candidates for public office.
Revised 5 May 2009