1275 Glenlivet Drive, Suite 100
Allentown, PA 18106
610-391-9131
Brenda@theofficequarters.com
Rooms for a Cause: Application
Through Rooms for a Cause, a program of The Office Quarters, nonprofit organizations serving the Lehigh Valley may use The Office Quarters’ conference room free of charge. Ten nonprofit organizations may participate annually and use the conference room for up to eight hours per month, on a space available basis. To apply, please complete the following application, including the signature page, and mail it to:
Brenda Ptacin, Office Manager
The Office Quarters
1275 Glenlivet Drive, Suite 100
Allentown, PA 18106
The Office Quarters will contact you after your application has been reviewed. Thank you for your interest!
Executive Director: ______________________________________________________
Organization Name: _____________________________________________________
Street Address: _________________________________________________________
City/State/Zip Code: _____________________________________________________
Mailing Address (if different than above): ___________________________________
Telephone: ______________________ Fax: ________________________________
Email Address: __________________________________________________________
Website Address: ________________________________________________________
Federal Tax (EIN) Number: _______________________________________________
Year founded: ________ Incorporated? ____________ When: _________
Required Attachments:
- List of Officers and Board Members
- Copy of current IRS Determination Letter 501 (c) (3) Status
Authorized Agency Representative:
I attest the foregoing information is complete and correct. I understand that any misrepresentation by me on this registration will be sufficient cause for cancellation of this registration.
____________________________ __________________________
Name (Please Print) Title
____________________________ ___________________________
Signature Date