AGENCY FORM

 

As Life Target wishes to maintain the highest quality of L.T. Emergency Proxy listing (L.T.E.P.), its goal is to keep the list as updated as much as possible.

Please contact Life Target if you see the option below that you wish to participate in:

*If your nonprofit organization is listed but is missing specific details or is inaccurate, please fill up the form with all the changes or additions you wish to be mentioned

*If your nonprofit organization is mentioned in the L.T. Emergency Proxy but you do not wish to be part of it, please fill up the form with only your name and title with the addition of your message directly in the Message box. A confirmation email will be sent to your  organization to confirm the authenticity of the request before we act on it.

*If your nonprofit organization is not mentioned in L.T. Emergency Proxy search engine but wish to be, please enter your information following the L.T. Emergency Proxy form. If one of the guidelines is not fulfilled by your organization, the registration will not be listed. Life Target is happy to welcome your agency and is thanking you for your trust.

Spiritual Affiliation:

LGBTQ:

Language:

Service charges:

Counseling:

Registration required:

Parental Approval:

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