Rainbow Referral Guides - List Your Organization Form


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List Your Organization

Complete the form below to have your non-profit agency listed in our directory. There is NO FEE for
non-profit agencies to be listed. Please remember to fax a copy of your 501(c)(3) certification to our office
at (714) 755-2983. If you have any questions about your listing please call Justine Wiggans at (714) 755-5463.

All submissions are subject to review, editing and approval by the staff of the Rainbow Resource Directory. We recommend that you review our current directories and make every effort to make your submission consistent with existing listings.

Your Contact Information (Not Used on the Listing)
First Name*
Last Name*
Phone Number*
Fax Number
E-mail Address

Agency Information for Listing
Agency Name (Line 1)*
Agency Name (Line 2)
Street Address*
Additional Address
City*
State*
Zip Code*
Phone Number
Fax Number
E-mail Address
Website Address (URL)
Languages Spoken by Staff
Areas You Serve
Admission Requirements
Payment Options
Funding Sources
Office Hours	Monday	to
	Tuesday	to
	Wednesday	to
	Thursday	to
	Friday	to
	Saturday	to
	Sunday	to
Directory Preferences	Los Angeles and Ventura Counties Orange County Riverside and San Bernardino Counties
Chapter Preferences (Select up to 3)
Agency Description*