Schuylkill Community Action

Add or Amend Entry in Service Directory Form

If you have any updates, corrections, or additions to the current Schuylkill County Human Service Directory, please fill this form (we will need to verify this information before any changes are made, so be sure to include proper contact information):

Updates, Corrections, Additions to the directory

The page number in the paper - PDF version of the directory where the change will appear:

Is this a correction or addition?

Correction Addition

Contact information. In case we need to contact you for futher information, please include your name, job title, email, and phone number (we cannot make any updates to the directory without having a contact to verify the change).

Service type: (please check all appropriate boxes)

Adoption Counseling/Foster Care Assistance	Housing (Loan and Grant Programs)
Adult Higher Education	Housing (Transitional)
Agriculture	Housing (Weatherization/Rehabilitation Programs)
Child Care	Immigration and Refugee Services
Children and Youth (Protection and Welfare)	Infants (Programs and Services)
Commerce	Information and Referral Services
Community Organizations/Foundations	Legal Services
Disability (Programs and Services)	Libraries
Early Childhood Education	Literacy
Education	Mental Health (Advocacy)
Emergency (Counseling/Therapy)	Mental Health (Counseling/Therapy)
Emergency (Mental Health)	Mental Health/Mental Retardation Services
Emergency Services (Clothing)	Nursing and Rehabilitation Homes
Emergency Services (Community)	Pregnancy (Programs and Services)
Emergency Services (Food)	Religious
Emergency Services (Shelter)	Saving & Debt Reduction Programs
Employment Services	Senior Services
Food Pantries/Food Assistance Programs	Substance Abuse (Drug and Alcohol Education/Prevention)
Free Tax Preparation Services	Substance Abuse (Drug and Alcohol Programs/Services)
Fuel, Utility, Mortgage and Rental Assistance	Support Groups
Health (Education and Prevention)	Teen Pregnancy (Programs and Services)
Health/Medical (Programs/Services)	Tobacco Cessation, Prevention, Education (Programs/Services)
Health/Medical Insurance/Assistance	Transportation
Home Health and Hospice Care	Veterans
Hospitals	Victim Assistance Programs
Housing	Volunteer Opportunities
Housing (Homeless Assistance)	Youth (Community-Based Programs)
Housing (Homeownership)

Agency Address:		City/State/Zip:
Phone:		Fax:
Toll Free Phone Number:		Office Hours:
Contact e-mail:		Agency web address:

Additional address and other basic information:

Agency Mission:

Program Name:
Contact:
Program Description:

Program Name:
Contact:
Program Description:

Program Name:
Contact:
Program Description:

Program Name:
Contact:
Program Description:

Program Name:
Contact:
Program Description:

Program Name:
Contact:
Program Description:

Program Name:
Contact:
Program Description:

Program Name:
Contact:
Program Description:

Program Name:
Contact:
Program Description:

Program Name:
Contact:
Program Description:

Program Name:
Contact:
Program Description:

Form Completion Instructions:

Complete the form by entering the data.
Once completed, click on the SUBMIT button above to send the information.

SCA is an Equal Opportunity Provider and Employer

SCA is firmly committed to the provision of assistance regardless of race, color, age, national origin, sex, familial status or disability.

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