Rockbridge Area 
                                       Information Line

An information & referral service providing information to the Citizens of the Rockbridge County, Virginia area via telephone, the Internet and a periodic resource guide
Organization Information Entry Form
PLEASE FILL ONE FORM WITH YOUR ORGANIZATION'S INFO, AND ONLY IF YOU ARE AUTHORIZED BY YOUR ORGANIZATION.  ORGANIZATIONS SUBJECT TO A LICENSING AUTHORITY TO OPERATE MUST INCLUDE THEIR LICENSING STATUS, AND ID WHEN APPLICABLE,  IN THE DESCRIPTION FIELD TO BE CONSIDERED FOR INCLUSION.

The information entered is for the use of the Rockbridge Area Information Line and will be made public.

Please search for your organization first, so as not to enter duplicates.

Organization: 
Category:  Please check the box(es) that apply to your organization's type.
Agriculture, Animal Care & Control  Associations, Clubs & Organizations  Businesses and Consumer Services 
Churches  Courts - Legal Services - Public Records  Education 
Emergency Services  Governmental Agencies  Health Services 
Recreation  Social & Human Services  Utilities - Telecommunications - Media 
Description: Enter data into the "Description" field as you would using a word processor; the form recognizes carriage returns.
License Required to Operate?   Yes No  Does this organization use volunteers?   Yes No 
If yes, Licensed by Federal State, 
or Local government? 
License or ID Number: 
 

Fee: Yes No 
Fee Description: 

  Types of volunteers:
Contact Person: Volunteer Coordinator if different:
Address: Address:
Street Street
City/State/Zip City/State/Zip
Mailing address if different. Mailing address if different.
City/State/Zip City/State/Zip
Email: Email:
Telephone:
Enter as many as 4 numbers		 Web Site: http://
Fax:
Please allow 24 hours for your information to appear on the site.

PLEASE submit only once - If you have difficulties with this form,

       If you can't find what you are looking for, please click here  to tell us.

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