Washington State Community Living Connections

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CLC Inclusion/Exclusion Criteria
Organization Inclusion Request Form

Organization Inclusion Request Form

If you are a service provider interested in being included in Washington State’s CLC Resource Directory, please fill in the following information and click on the Submit button. Someone from a local CLC will then contact you.

Organization Name *

Address

City

State

ZIP Code

Select a County *

Contact Name *

Email *

Phone *

What is your organization type? *

Enter brief description of your services and programs:

Your Name *

Title

Note: * is a required field