Unity Impact's Resource Directory Form

Administering to those needing assistance in our local area, or beyond,
by building a network of individuals, organizations
and businesses in our community.

Unity Impact is a local non profit corporation serving the community of Huntington Beach.

We are creating a network which will showcase resources, services, businesses and events in our community that assist our local residents.

If you are an individual, organization or business, in Huntington Beach, that might be interested in being included in our resource directory, please complete this short form.

If you have questions, of any sort, please feel free to contact us by email or phone! This Resource Directory is being built by "neighborhood" for the simplicity of it's users.

Thank you,

Stacy L. Massey

UnityImpact.org
714-325-8800

info@unityimpact.org

EIN#: 82-294888

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In which HB Neighborhood is your business located? *

What best describes your business? *

Business or Organization Name *

Your First Name *

Your Last Name *

What is your role? *

Owner

Partner

Manager

How long have you worked with this business? *

Under 1 Year	1-5 Years
6-10 Years	Over 10 Years

Business Address 1 *

Business Address 2

City *

State *

Zip Code *

Best Contact Phone *

Email Address *

Text-abled Phone #:

Do you have a website?

Yes

No

Not sure

It needs help

Your website URL

Does Unity Impact have permission to share your contact information with other businesses in your neighborhood? *

Yes

No

Depends on the circumstance

Best time of day to contact you? *

Morning

Afternoon

Evening

What days of the week are best to contact you?

Please describe how your business contributes to your surrounding neighborhood? What are some of the resources it may be able to offer in an emergency? *

Are there any signature events that your business holds? Or maybe some that it would like to hold?

How can Unity Impact come along side to help serve you, your business or your neighborhood?

Any additional comments, information or instructions you would like to share?

Signature *

clear

Date Form Is Complete: * +

Beach Blvd	Bolsa Chica
Central Park	Downtown HB
Goldenwest	Huntington Harbor
Southeast HB	Sunset Beach
Other Other

Entertainment	Fitness & Wellness	Nonprofit
Places to Stay	Professional Business Service	Religious
Restaurants & Pubs	Retail & Rentals	Salons
Other or further description Other or further description