Accreditation Application (payment in full up front)

Accreditation

Inform USA Accreditation is a five phase process that measures information and referral organizations against industry standards.

Non-Member Price: $9,000

Member Price: $6,000

Let's Get Some Additional Information

Please complete the requested information below to finish adding Accreditation Application (payment in full up front) to your cart.

Date form is completed:

Agency/Organization Name:

When does your current accreditation cycle end (list month and year)? For first time applicants, put NA. **Please note - organizations are allowed to apply for accreditation 1 year prior to when their current accreditation cycle ends. If you need to apply earlier than that for budgetary reasons, please contact accreditation@informusa.org to be considered on a case-by-case basis.

First time Accreditation? or Reaccreditation? Is your organization applying for a first time accreditation, or a re-accreditation?

Legal Status

The year your organization was incorporated: If you are a government entity, you can skip this question.

Primary Type of I&R Please indicate which area your organization focuses on MOST. If you do multiple types of I&R, please indicate that in the next question.

Name of Information and Referral program:

City and State/Province of I&R program:

The year your program was established: Note: Only applicable if different than the date the organization was incorporated.

Your I&R program's website:

Estimated annual I&R program budget: Gold or Silver applicants must indicate their annual budget.

# Contacts/year (calls, emails, texts, chats or walk-in)

Geographic area served:

Number of I&R Staff

Population of area served: Note: Please use the following website(s) to obtain this data - United States (www.census.gov) and Canada (www.statcan.gc.ca)

Do you have any software conversions planned during your Accreditation process?

Do you subcontract a portion of your I&R services to another organization? (If yes, please describe what portion of services (call handling, resource database, etc), and share the name of the subcontractor)

Why is your organizational seeking Accreditation? Please select all that apply.

If you are required to go through Accreditation, please provide a description/reference (ex. name of contract, specific statute language)

Do you hold any other Accreditations? Please select all that apply.

Lead Contact (full name): Must include at least one point of contact. It is highly recommended to have a secondary.

Lead Contact (job title):

Lead - Years of I&R Experience

Lead Contact (email):

Lead Contact (phone number):

Alternate Contact (full name):

Alternate Contact (job title):

Years of I&R Work Experience - Alternate Contact

Alternate Contact (email):

Alternate Contact (phone number):

Database Contact (full name):

Years of I&R Work Experience - Lead Database Staff

Database Contact (email):

What software do you use for your resource database?

Size of Database Curation Team (# of FTE's)

Resource database maintained by another entity?

If externally maintained, please list name here:

Is that organization Accredited by Inform USA?

Consent for Recordings of Meetings Do you give Inform USA permission to record the online meetings we have with your organization for training purposes (database review, virtual site visit)?

Consultation Agreement: I agree, on behalf of my organization, that I have read and agree to the Accreditation Agreement and have informed my Board President (or equivalent) about this application.

Name of person completing Application & signing Consultation Agreement:

Accreditation Payment Preference How would you like the invoice to be set up? *For Inform USA members, we offer the ability to split the cost of Accreditation into two payments of $3,100 each; one installment must be paid prior to starting the process.

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Accreditation Application (payment in full up front)

Accreditation

Let's Get Some Additional Information

Please complete the requested information below to finish adding Accreditation Application (payment in full up front) to your cart.

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