Program Directory Survey – Kelly Brush Foundation

Program Information Update

OUR GOAL: to provide anyone with an SCI the information they need to participate in your programming based on their interests and location. To do this, we need the best information possible:

all programming locations (for the geo-locator)
all sports/activities you offer (which they can search by)
contact info they need to get in touch with you as simply as possible

If any of the information you enter conflicts with the info provided by DSUSA, US Paralympics, or what is generally available publicly, we will use the information you provide here. If we have the right information for you, but you’d like to add additional locations, please skip to the bottom and click “Yes” under “Do you have additional programming locations”.

Program Info Update

Program Name:
As you'd like it to be seen by prospective participants
Programming Address
NO PO BOXES. If you don't have a program location, just input your city and state. You can add secondary programming locations below.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Website
Phone
Sports/Activities Offered:
Please list all offered at this location, separated by semicolon ";"
Do you have additional programming locations?
- Yes
- No
Additional Programming Locations:
Second Location Name
Please list it as you'd like us to display it. For example, "Kelly Brush Foundation - Burlington".
Second Location Address (no PO boxes)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Second Location Email (if different)
Second Location Website (if different)
Second Location Phone (if different)
Second Location Sports/Activities Offered
Please list all offered at this location, separated by semicolon ";"
Another additional location?
- Yes
- No
Third Location Name
Please list it as you'd like us to display it. For example, "Kelly Brush Foundation - Burlington".
Third Location Address (no PO boxes)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Third Location Phone (if different)
Third Location Email (if different)
Third Location Website (if different)
Third Location Sports/Activities Offered
Please list all offered at this location, separated by semicolon ";"
Still more additional locations?
- Yes
- No
Fourth Location Name
Please list it as you'd like us to display it. For example, "Kelly Brush Foundation - Burlington".
Fourth Location Address (no PO boxes)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Fourth Location Email (if different)
Fourth Location Website (if different)
Fourth Location Phone (if different)
Fourth Location Sports/Activities Offered
Please list all offered at this location, separated by semicolon ";"
If you have five or more locations, please call us! Stephanie - 802-846-5298

Program Information Update

Program Info Update

Additional Programming Locations: