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Home My WebLink About211 HelplinePalm Beach/Treasura Coast ~- _,~' TM GetConnected. GetAnswers. AFFILIATE AGREEMENT To ensure continuity of care and support to clients, 211 Palm Beach/Treasure Coast enters into the following agreement with: City of Sebastian CICS0301 (Print or type your agency name here.) 211 Palm Beach/Treasure Coast agrees: 1. To refer appropriate callers to the Affiliate without regard to race, color, creed, disability,' national origin; age, sex, sexual orientation or economic status for assessment/on-going services. 2. To be available as a resource to the Affiliate's clients 24 hours a day for telephone counseling and information and referral to community resources. 3. To be available to the affiliate's staff for information about and referrals to community resources. The Affiliate agrees: 1. , To receive clients without regard to race, color, creed, disability, national origin, age, sex, sexual orientation or economic status who are referred by 211 Palm Beach/Treasure Coast. 2. To advise clients of the 24-hour availability of 211 Palm Beach/Treasure Coast services. 3. To advise staff of the availability of 211 Palm Beach/Treasure Coast as a resource. 4. To update 211 Palm Beach/Treasure Coast when changes arise within the Affiliate. This letter of agreement will remain in force until terminated by either party contingent upon thirty (30) days written notice. 211 PALM BEACH/TREASURE COAST: Susan K. Buza; Executi~f e Director / ) Q Date Si d 211 PALM BEACN/TREASURE COAST ~ P.O. BOR 3588 ~ LANTANA, FL 33465 ~ TEL 561.541.8637 ~ FAX 561.541.8639 THE CENTER FOR INFORMATION ~ CRISIS SERVICES www.211 palmbeach.org www.211 treasurecoast.org ~~CHILDREN & FAMILIES G' AGN ~b c~~~~ 'n/n..tl1' ~ c~c~ss ,,,,~~,,., c.. ~~~ i - ....,. ~,. ..~. nF°-as l-Z~fo/ Date Signed Palm Beach/Treasure Coast ~~-~'~ na GetConnecfed. GetAnswers. AFFILIATE AGREEMENT To ensure continuity of care and support to clients, The Center for Information and Crisis Services enters into the following agreement with: City of Sebastian (Print or type your agency name here.) The Center for Information and Crisis Services agrees: To refer appropriate callers to the Affiliate without regazd to race, color, creed, disability, national origin, age, sex, sexual orientation or economic status for assessment/on-going services. To be available as a resource to the Affiliate's clients 24 hours a day for telephone counseling and information and referral to community resources. To be available to the affiliate's staff for information about and referrals to community resources. The Affiliate agrees 1. To receive clients without regard to race, color, creed, disability, national origin, age, sex, sexual orientation or economic status who are referred by The Center. 2. To advise clients of the 24-hour availability of The Center's Services. 3. To advise staff of the availability of The Center as a resource. 4. To update The Center when changes arise within the Affiliate. This letter of agreement will remain in force until terminated by either party contingent upon thirty (30) days written notice. The Center for Information and Crisis Services, Inc. `. Executive Director .~ G J Date Sign d [ .. g-3-o5 Date Signed 211 PALM BFACN/TREASURE COAST I P.O. BDN 3588 I LANipNA, FL 33465 I TEL 561.547.8637 I fAR 561.547.8839 THE CENTER FOR INFORMATION & CRISIS SERVICES www.211 paimbeach.org www 211treasurecoast.org 6'ncx6 CHILCRHJS ' ~ ~~ I~iU4~ ~lni ~~f ~i: j' Ly n:. ~„ CHILDREN ~' ', ~ ~'; Chit ~ }~~~° & FAMILIES ~ ;,.- t. ::.a., . , ....:. ELDER July 29, 2005 Through its information & referral service, 211 Helpline is the central cleazinghouse for callers who need help "finding a way" by contacting appropriate human service and governmental agencies. By having current information in our database, agencies receive appropriate, quality referrals through our 24 hour/7 day per week service. 211 Helpline is a telephone based information and referral, counseling, crisis intervention and suicide prevention. service. 211 Helpline currently serves Palm Beach, Martin, St. Lucie, Indian River and Okeechobee counties. In order for us to do a quality job and in order for your organization to receive quality referrals, we need to be sure that our resource database is correct and current. PLEASE review the attached information regazding your organization; make any changes or indicate that no changes aze required and mail. or fax this back to us (attention Jesus Rodriguez) by August 31, 2005. Also we are asking you to complete and return the enclosed Affiliate Agreement which outlines an understanding of our working relationship. Jesus Rodriguez Human Services Research Specialist The Center for Information & Crisis Services PO Box 3588 Lantana, FL 33465 Voice: (561) 383-1134 Fax: (561)547-8639 E-Mail: jesus.rodriguL7(a';211pbtc.ora Agency Information Agency: City of Sebastian 1225 Main Street City Complex Sebastian, FL 32958 (772) 589-5330 FAX: (772) 589-5570 In charge: AI Minner City Manager Hours: Monday-Friday / 8 am-4:30 pm Website: http://www.cityofsebastian.org Agency Email: aminner@cityofsebastian.org Agency Type: Municipal Government Federal Tax ID: Agency #: CICS0301 Last Formal Update: 10/27/200 Municipal government. Program Information Prbglram Name: police Department (Sebastian) Agency Name: City of Sebastian 1201 Main Street Sebastian, FL 32958 (772) 589-5233 Non-emergency calls FAX: In charge: .lames Davis Hours: Everyday/24 hours Fees: No fees charged. Intake Procedure: Contact by phone. Eligibility: No restrictions. Languages: English. Service Area: Sebastian Website: http://www.sebastianpd.orgl Email: Police Chief Program #: CICS0301AB Last Formal Date: 10/27!2003 Local law enforcement agency. Program Information Program Name: City of Sebastian Agency Name: City of Sebastian 1225 Main Street City Complex Sebastian, FL 32958 (772) 589-5330 FAX: (772) 589-5570 In charge: AI Minner Hours: Monday-Friday / 8 am-4:30 pm Fees: No fees charged. Intake Procedure: Contact by phone. Eligibility: No restrictions. Languages; English. Service Area: City of Sebastian Website: http://www.cityofsebastian.org Email: tmoore@cityofsebastian.org City Manager Program #: CICS0301AC Last Formal Date: 10/27!2003 Municipal government. Program Information Program Name: Handicapped Seif Evaluation Committee Agency Name: City of Sebastian 7225 Main Street City Complex Sebastian, FL 32958 (772)589-5330 FAX: In charge: James Sexton Hours: Monday-Friday 18 am-4:30 pm Fees:. No fees charged. Intake Procedure: Contact by phone. Eligibility: Contact program. Languages; English Service Area: City of Sebastian Website: http:Jlwww.cityofsebastian.org Email: jsexton@cityofsebastian.org Human Resources Director Program #: CICS03O1AD Last Formal Date: 1012712003 Oversight group to make Sebastian accessible to the handicapped, make recommendations to correct any violations of codes and standards mandated by State statute. Program Information Program Name: Municipal Golf Course (City of Sebastian) Agency Name: City of Sebastian 101 E. Airport Drive Sebastian, FL 32958 (772) 589-6801 Manager's Office (772) 589-6800 Golf Shop (772) 589-6803 Restaurant (772) 589-6802 Starter FAX: In charge: Greg Gardner Hours: Fees: Call for information. Intake Procedure: Contact by phone. Eligibility: Call for information. Languages; English. Service Area: City of Sebastian Website: http://www.cityofsebastian.org Email: Director of Golf Operations Program #: CICS0301AA Last Formal Date: 1 012 7/2 0 0 3 Municipal course operated by the City of Sebastian for residents and visitors.