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Nonprofit Organization Name:
*
Website address:
Agency Contact Name
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First Name
Last Name
Contact's Title:
Email
*
Verify Email
*
Phone
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Mission Focus (Check all that apply)
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Homelessness / Housing
Food Security
BIPOC Communities Focus
Immigrants & Refugees
LGBTQIA Rights & Well-Being
Seniors / Aging
Children & Youth
Education
Arts
Veterans
Legal Aid / Domestic Violence
Environment
Social Justice
Health Care Access
Behavioral Health & Substance Abuse Recovery
Other
If 'Other' please specify mission focus:
What length of service are you requesting?
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select one
1-year placement
3 to 6 month placement
Project-specific placement
Can your agency offer a stipend?
*
select one
Yes
No
Potentially
Postion type(s) needed:
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Administrative Assistance
Communications / Marketing
Database / IT project needs
Development assistance / consultation
Finance
Program - Direct Service
Program - Support / Coordination
Board Consultation
Other
If 'Other' please specify position:
Estimated weekly hours desired for position
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1 to 9 hrs/wk
10-15 hrs/wk
16-20 hrs/wk
Other
Position Title & Primary Role
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Three to five sentences
When do you need placement(s) to start?
*
Special Requests / Notes
How did you hear about Companis and our services?
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County
*
In which county is your agency based?
select one
King
Snohomish
Status (For Staff)