1) Organization Name
2) Contact Person
3) Phone Number(s)
4) Electronic Mail Address (E-mail)
5) Website URL
6) Mailing Address / Street / P.O. Box
7) City, State, Zip
8) Work Focus Areas Business / Microfinance Community Development Disaster Relief Education Evangelism Health Care / Nutrition Environment / Water Child Sponsorship / Orphan Care Government Social Justice HIV Awareness / Education Medical Short Term Mission Trips Other
9) Geographic Area(s) 1. Artibonite 2. Centre / Center 3. Grand Anse 4. Nord / North 5. Nord-Est / Northeast 6. Nord-Ouest / Northwest 7. Oeust / West 8. Sud / South 9. Sud-Est / Southeast All Departments
10) Cities or Towns
11) Please provide a short description of your work
12) Is this an update of previous information? Yes No Don't know
