Our Hometown eCommunity in the Heart of the Blue Ridge Mountains
The following information will be used to create a Web page for your agency or organization. Please complete the following form. When you are sure all information is correct, click the submit button.
Would your site best be grouped with government agencies or civic and non-profit organizations?
government
civic/non-profit
Name of Office/Agency/Organization
911 Address (Street Address, City)
Mailing address if different from above.
Phone (include area code: format 336-372-5555)
Fax (include area code: format 336-372-5555)
Email Address (enter NA if not available)
In straightforward language, please include a full description of you office or agency, its mission and the services provided for the public and hours you are open. Please imagine you are writing this for a citizen who is seeking a service that might be provided at your office. Include the names of key staff you wish to have listed on the website and phone/extension and email addresses if different from the main number.
Descripton (limit 500 words)
Hours Office Open (limit 50 characters)
List any URLs (Web addresses) that you wish to have linked from your page that individuals coming to your site might find helpful. Links
Do you have comments or questions about the information requested?
Name of Contact Person Completing This Form
Phone Number of Contact
Email Address of contact