<div class="fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_1_1 1_1 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;"> Complete all applicable information. If a field does not apply to your organization, please specify N/A. #wpforms-21741 { --wpforms-field-border-color: rgba(0, 0, 0, 0.25); --wpforms-field-border-color-spare: rgba(0, 0, 0, 0.25); --wpforms-field-text-color: rgba(0, 0, 0, 0.7); --wpforms-label-color: rgba(0, 0, 0, 0.85); --wpforms-label-sublabel-color: rgba(0, 0, 0, 0.55); --wpforms-button-border-radius: 50px; --wpforms-button-background-color: #0044b5; --wpforms-background-color: rgba(0, 0, 0, 0); --wpforms-field-size-input-height: 43px; --wpforms-field-size-input-spacing: 15px; --wpforms-field-size-font-size: 16px; --wpforms-field-size-line-height: 19px; --wpforms-field-size-padding-h: 14px; --wpforms-field-size-checkbox-size: 16px; --wpforms-field-size-sublabel-spacing: 5px; --wpforms-field-size-icon-size: 1; --wpforms-label-size-font-size: 16px; --wpforms-label-size-line-height: 19px; --wpforms-label-size-sublabel-font-size: 14px; --wpforms-label-size-sublabel-line-height: 17px; --wpforms-button-size-font-size: 17px; --wpforms-button-size-height: 41px; --wpforms-button-size-padding-h: 15px; --wpforms-button-size-margin-top: 10px; --wpforms-container-shadow-size-box-shadow: none; } #wpforms-21741 { .wpforms-container.wpforms-container-full { width: 100%; } } Please enable JavaScript in your browser to complete this form. Please enable JavaScript in your browser to complete this form. ORGANIZATIONAL INFORMATION Organization Name: * Alternate Name (if applicable): Year Incorporated: * Email: * Legal Status: * --- Select Choice --- For Profit Government Nonprofit Faith Based Corporation S Corporation B Corporation C Corporation LLC Other Organization Website URL: Tax Status: * --- Select Choice --- 501(a) 501(c)(3) Charity Community Agency Commercial Other Tax ID: * Description: * ACKNOWLEDGEMENT Name of Person Completing This Form: * First Last Email of Person Completing This Form: * Submit

<div class="fusion-layout-column fusion_builder_column fusion-builder-column-7 fusion_builder_column_1_1 1_1 fusion-flex-column" style="--awb-bg-size:cover;--awb-width-large:100%;--awb-flex-grow:0;--awb-flex-shrink:0;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:10px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-flex-grow-medium:;--awb-flex-shrink-medium:;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-flex-grow-small:;--awb-flex-shrink-small:;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;"> Complete all applicable information. If a field does not apply to your organization, please specify N/A. Complete a separate form for each program your agency offers. #wpforms-21763 { --wpforms-field-border-color: rgba(0, 0, 0, 0.25); --wpforms-field-border-color-spare: rgba(0, 0, 0, 0.25); --wpforms-field-text-color: rgba(0, 0, 0, 0.7); --wpforms-label-color: rgba(0, 0, 0, 0.85); --wpforms-label-sublabel-color: rgba(0, 0, 0, 0.55); --wpforms-button-border-radius: 50px; --wpforms-button-background-color: #0044b5; --wpforms-background-color: rgba(0, 0, 0, 0); --wpforms-field-size-input-height: 43px; --wpforms-field-size-input-spacing: 15px; --wpforms-field-size-font-size: 16px; --wpforms-field-size-line-height: 19px; --wpforms-field-size-padding-h: 14px; --wpforms-field-size-checkbox-size: 16px; --wpforms-field-size-sublabel-spacing: 5px; --wpforms-field-size-icon-size: 1; --wpforms-label-size-font-size: 16px; --wpforms-label-size-line-height: 19px; --wpforms-label-size-sublabel-font-size: 14px; --wpforms-label-size-sublabel-line-height: 17px; --wpforms-button-size-font-size: 17px; --wpforms-button-size-height: 41px; --wpforms-button-size-padding-h: 15px; --wpforms-button-size-margin-top: 10px; --wpforms-container-shadow-size-box-shadow: none; } Please enable JavaScript in your browser to complete this form. Please enable JavaScript in your browser to complete this form. Service Name: * Agency Name: * Alternate Agency Name (if applicable): * Fee: * Organization Website URL: Wait Time: * Organization Email: Eligibility: * License: Interpretation Services: * Accreditation: Payment Accepted: * Application Process: Required Document: * Available for Directory: * --- Select Choice --- Yes No Language: * Show Location Name on Directory: * --- Select Choice --- Yes No Has Volunteer Opportunties: * --- Select Choice --- Yes No Available for Referral: * --- Select Choice --- Yes No Volunteer Opportunity Description and Requirements: Show on Map: * --- Select Choice --- Yes No Service Area: * Service Area Description: * Keywords of services provided: * Will be used to determine search taxonomies. Description: * Short Description: * CONTACT INFORMATION Name: * Email: * Organization: * Phone: * Title: * Department: * Confidential * --- Select Choice --- Yes No Phone Number(s) for Program/Service: * Schedule: * Location(s). For each include the location name, physical address, and mailing address (if different). * Additional Notes: * ACKNOWLEDGEMENT Name of Person Completing This Form: * First Last Email of Person Completing This Form: * Submit

211: Get Listed

Are you a nonprofit in Kansas that would like to list your program(s) in the 211 database? It’s easy!

Complete the agency and program forms below. Remember, an agency is the organization that hosts the program and programs are specific services, such as an employment workshop for adults. Please complete all required fields. If it does not apply to your agency or program, list N/A. View our database inclusion/exclusion policy here.

Questions? Contact Michele Grimm, United Way 211 Coordinator, at (316) 267‑1321, ext. 4301, or mgrimm@unitedwayplains.org.

211 Agency Formkgoertzen2024-05-15T18:00:40-05:00

211 Agency Form

Complete all applicable information. If a field does not apply to your organization, please specify N/A.

211 Program Formkgoertzen2024-05-15T18:00:35-05:00

211 Program Form

Complete all applicable information. If a field does not apply to your organization, please specify N/A. Complete a separate form for each program your agency offers.

Service Name:

Agency Name:

Alternate Agency Name (if applicable):

Fee:

Organization Website URL:

Wait Time:

Organization Email:

Eligibility:

License:

Interpretation Services:

Accreditation:

Payment Accepted:

Application Process:

Required Document:

Available for Directory:

Language:

Show Location Name on Directory:

Has Volunteer Opportunties:

Available for Referral:

Show on Map:

Service Area:

Service Area Description:

Keywords of services provided:

Will be used to determine search taxonomies.

Description:

Short Description:

CONTACT INFORMATION

Name:

Email:

Organization:

Phone:

Title:

Department:

Confidential

Phone Number(s) for Program/Service:

Schedule:

Location(s). For each include the location name, physical address, and mailing address (if different).

Additional Notes:

ACKNOWLEDGEMENT

Name of Person Completing This Form:

First

Last

Email of Person Completing This Form:

211 Anger Management and Parenting Resources Formkgoertzen2024-05-16T09:53:12-05:00

211 Anger Management and Parenting Resources Form

Parenting classes and anger management classes will be published in their respective resource guides. Resource guides are available to agencies and consumers in print and available for download at unitedwayplains.org/211. This information is updated regularly. Please contact 211 or check the website for the most current guides.

Information is provided as a community service and does not necessarily constitute endorsement or approval by United Way of the Plains.

List only one class per form. Submit form as many times as needed.

PROGRAM INFORMATION

Course Name:

Agency Name:

Type of course.

Physical Address:

Address Line 1

Address Line 2

City

State

Zip Code

Number of Sessions:

Time:

Start Date:

Cost:

Name of Contact Person:

First

Last

Contact Phone:

Contact Email:

Other Information:

Handicap Accessible?

Geography Served:

Upload brochures or other documentation to aid in the understanding of services provided. (File type must be .pdf or .jpg, and smaller than 2MB.)

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

ACKNOWLEDGEMENT

Name of Person Completing This Form:

First

Last

Email for Person Completing This Form:

211: Get Listed

Are you a nonprofit in Kansas that would like to list your program(s) in the 211 database? It’s easy!

211 Agency Form

211 Program Form

211 Anger Management and Parenting Resources Form

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