Instructions: Please fill out one application for each program or service. (For example: Human Services Agency offers multiple programs and may have different contacts and locations for each, so they would complete an application for each program.) Thank you!

Questions? Contact us: 570-723-0520

Name of the Resource/ Service/ Program or Informal Support?:


Public Phone Number:


Website URL if available:


Physical Address:


Mailing Address:


Email Address:


Geographic Area Served? (Must cover all or part of Tioga County):


Population Served (explain any eligibility restrictions here): eg. "18 and over"


Brief Description (i.e. mission, days/hours, service provided, etc. [100 words or less]):


Category (Choose as many as apply):


    • If Other, Please Specify:

    **If "other" is specified, we will consider creating other categories in our Resource Directory if that category garners a lot of requests.**

    Keywords( i.e. words that people may search to find this resource, must be a comma separated list):


    Volunteering Opportunities?

    Volunteer Coordinator Name:


    Volunteer Coordinator Email:


    Email address for person submitting this form:


    Volunteer Coordinator Phone:


    Yes, please use my logo on www.tiogapartnership.org for the purpose of linking people to our volunteering information and/or website. (Email jpeg file logo to cevert@tiogapartnership.org)





    **By providing information in this application you give permission for all or part of the information you provide to be included in the online directory housed on www.tiogapartnership.org website and other printed materials associated with the Partnership Resource Directory that will serve to link people with programs and services in Tioga County, PA.**