Program Information

Agency Name

Program Name

Literacy Program Website
program or agency website

Contact Person

LBS or LINC

If your agency has both an LBS and a LINC program, please do a separate form for each.

Address

Phone - TTY

Phone - Voice

Fax

Program Information
describe your program

Images & Video
let people see you and see your program

Your Logo
your agency's logo

choose file

Your Building
photo to help people find you
(landscape / wide photos only please)

choose file

Your Classroom
photo of teachers / students
(landscape / wide photos only please)

choose file

Video (YouTube or Vimeo)
optional - share a video about your program

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