Complete this form to request your Organization be listed in the St. Cloud OUT Resource Directory

St. Cloud OUT serves the GLBTA community in the greater St. Cloud area. The Resource Directory assists in locating groups or organizations of interest to the GLBTA community.

Please provide as much information as you can about your organization or group in the form below. Upon review, you may be contacted for additional information before your organization is listed in the Resource Directory.

Thank you for your interest in promoting your organization to the St. Cloud area GLBTA community.

Requester Information

(For verifying information only. Will not be used in Resource Directory)
Your Name:	*Required
E-mail:	*Required

Organization Information: (For use in Resource Directory)

Organization:	*Required
Contact Person:
Contact Phone:
Contact E-mail:
Web Address:
Mailing / Street Address:

Mission Statement:

Audience:

Purpose Summary: (check all that apply)

Social	Support	Advocacy	Activism
Education	Events	Coalition	Financial

Organized Meetings:

Activities: