Get New York State Condom Program Organization Information And ...

Filling out the New York State Condom Program Organization Information and Attestation form online is a streamlined process designed to make your application straightforward. This guide will walk you through each step of the form to ensure that you complete it accurately and efficiently.

Follow the steps to complete your Organization Information and Attestation form online.

1. Press the ‘Get Form’ button to access the Organization Information and Attestation form and open it in your preferred editor.
2. Begin by entering your organization's name and web page, if applicable. Ensure that this information is correct, as it will be essential for your application.
3. Next, provide the details of an individual authorized to order supplies, including their first name, last name, email address, title, address, city, state, phone number, extension, zip code, and fax number.
4. If there are additional individuals authorized to order supplies, repeat step three for each individual, ensuring all required fields are completed.
5. Indicate your organization's type by checking all applicable boxes from the options provided.
6. In the next section, check all applicable services provided by your organization.
7. Identify the populations to which you anticipate distributing safer sex supplies, ensuring to check all relevant categories.
8. Next, specify the multi-county regions in which you will distribute supplies. Check all that apply and be sure to provide primary counties, cities, neighborhoods, or zip codes where supplies will be distributed.
9. Indicate how you learned about the program by selecting one of the provided options.
10. Describe how you plan to distribute the supplies by checking all relevant methods.
11. In the attestation section, review the statements carefully. By signing, you confirm that all information is accurate and that the persons listed are authorized to request supplies. After reading, sign and date the form, and provide your printed name, title, telephone number, and email address.
12. Once you have filled out the form completely, you can save changes, download, print, or share it according to your needs.

Start filling out your New York State Condom Program Organization Information and Attestation form online today!