Interested in joining baltimore connect?

Name

First Name

Last Name

Phone

(###)

###

####

Organization Name

Position at Organization

Organization Address

What populations does your organization serve?

(i.e certain age group, gender, etc)

Does your organization serve Baltimore City Residents?

Yes

Some clients are Baltimore City Residents

Unsure

Approximately how many people does your organization serve?

Please provide a link to your organization's website and/or social media pages.

Why would you like to join Baltimore CONNECT?

How did you hear about us?

If you selected "Other," or would like to provide more details, please write here!