humanresources@auburnwa.gov

Auburn Community Resource Center Provider Application

Full Name

First Name

Last Name

Company Name

Phone Number

Email

Briefly explain what services your company provides to clients:

What area does your company serve? (E.g. King County, Pierce County, Only Auburn, Etc.)

Please describe the demographic your company serves. (E.g. Homeless, Women, DV victims, Etc.)

Providers are needed weekly on Thursdays from 1:30pm-3:30pm.

What weeks are you available to commit to attending in person? (select all that apply):

1st Thursday of the month

2nd Thursday of the month

3rd Thursday of the month

4th Thursday of the month

I am available every week

How did you hear about us?

Resource Center Walk-In

Community Court Referral

Flyer

Web Page

disregard this