Texas Health and Human Services CommissionApplication for:
TEXAS NONPROFIT COUNCIL
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Please complete this application in a brief yet informative manner. Eligibility will be determined from theinformation submitted on this application. No resumes will be considered. If questions are not applicable, enter
Name: Employment InformationHome Address:
Send Correspondence to:
Are you 18 yearsof age or older?
Applying as arepresentative for
Statewide NonprofitOrganizationLocal GovernmentFaith-Based OrganizationCommunity-BasedOrganizationConsultant to NonprofitCorporationStatewide Association of Nonprofit Organizations
(highest level completed first)School Name:Degree: Field of Study:School Name:Degree: Field of Study:
Female American Indian/Alaskan NativeBlack WhiteAsian/Pacific Islander HispanicOther:______________
How were younotified of thisapplication?
HHSC WebsiteHHSC Distribution ListHHSC Staff Other: ______________