Business/Community Pledge - The Campaign to Change Direction

Describe Your Group/Organization

Business/Organization Name*

Name of the company, group or organization you represent.

Type of Organization*

Pick the option below that best describes your organization

I would like to be part of a regional effort in:

Organization/Group Description*

Provide a brief description of your organization/group.

Military Branch

Choose the military branch below that your organization either serves or supports.

Active Duty or Veteran?

Thank you for serving our country! Please let us know if you are a veteran or active duty.

School/University Type

Indicate the level of education.

Government

Choose the branch of the government below.

Website

Address

Street Address City State / Province / Region ZIP / Postal Code Country