CUAH Network Member Information

Please complete this form to submit your organization's information so we may add it to the CUAH Network Members page of our website. In addition to filling out this form, please email your organization's logo, preferably in .png format, 72ppi (pixels per inch), and square shaped (so nothing gets cut off) to digital@cuahmcmd.org, subject line "[Your Organization Name] - CUAH Member Logo." We cannot list your organization on our website without all the requested information.

Member Organization Full Name

Member Organization Acronym

(If applicable.)

Brief Summary of Organization (240 CHARACTER LIMIT)

(240 CHARACTERS MAXIMUM. You may use this website to calculate the number of characters: http://www.javascriptkit.com/script/script2/charcount.shtml)

Link to Organization's Website

(This can be your organization's Facebook page if you do not have a website.)

Link to Organization's Facebook Page

(If applicable. CUAH will like your organization on Facebook.)

Link to Organization's Twitter Page

(If applicable. CUAH will follow your organization on Twitter.)

Link to Organization's Instagram Page

(If applicable. CUAH will follow your organization on Instagram.)

Name of Person Filling Out This Form

Email of Person Filling Out This Form