Become a Chapter - Contact Us

Organization Name*

Date*

State*

Primary Contact Person *

First Name*

Last Name*

Primary Contact Title

Phone Number*

Email Address*

I am an individual interested in learning more about establishing a chapter in my community

Do you have experience with a chapter of The Arc? (check all that apply)

Why do you want to establish a chapter of The Arc in your community?

I’m a parent interested in services for my child
I lived in a community with a chapter and have relocated to a community without a chapter
People with intellectual and/or developmental disabilities and their families are underserved or dissatisfied with their services
My community doesn’t have enough advocates helping individuals and their families
Other (specify):

What do you want to achieve by establishing a chapter of The Arc? (check all that apply)

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Does anyone in your group have experience with a chapter of The Arc? (check all that apply)

Why does your group want to establish a chapter of The Arc in your community?

We’re parents interested in services for our children
Some of us lived in a community with a chapter and have relocated to a community without a chapter
People with intellectual and/or developmental disabilities and their families are underserved or dissatisfied with their services
My community doesn’t have enough advocates helping individuals and their families
Other (specify):

What do you want to achieve by establishing a chapter of The Arc? (check all that apply)

What year was your organization established?

What is your organization’s annual revenue?

How many professional staff do you employ?

What is your geographic service area (cities, counties)?

Has your organization ever been affiliated with The Arc?

What services do you currently offer? (check all that apply)

Why does your organization want to affiliate with The Arc? (check all that apply):

We’re interested in joining a national network
The Arc’s brand is recognized and valued in our community
We’re interested in becoming more involved in state and federal public policy advocacy
We believe The Arc’s resources will enhance our organization
People in our organization have had positive experiences with The Arc
Other (specify)

Do you have any questions about establishing a chapter of The Arc in your community?