EROD OnlineForm New Submittal.txt 	Date: 1/24/2007


New Organization Submittal Form

General Information

Use this form to suggest your organization for addition in the 
Education Resource Organizations Directory (EROD). To find out 
if your organization qualifies to be in the Directory, please 
read our "Criteria for Inclusion" statement. If the 
information you submit is added to EROD, it will be available 
to the public at http://www.ed.gov/Programs/EROD/.

You don't have to provide information for every item on this 
collection form, but items with an asterisk (*) are required. 
If you have any questions, please contact us at 
mailto:erod@ed.gov, or check out our sample form.

OMB # 1800-0012


Location Information

* Service, Program, or Organization Name
* Address 1
  Address 2
  Address 3
* City
* State  
* Zip


Contact Information

Please input either the phone number or the toll free number, 
or both.
 
* Phone e.g.: (123) 456-7890 x123
* Toll-free  
  Toll-free Restrictions
  TTY
  Fax
* E-mail Address
  E-mail Address 2
  WWW Address


Operating Information

Director's Name 1	Honorific	First	Middle	Last	Suffix
Director's Title 1


Director's Name 2	Honorific	First	Middle	Last	Suffix
Director's Title 2


Director's Name 3	Honorific	First	Middle	Last	Suffix
Director's Title 3


Contact's Name		First		Last
Contact's Title

Sponsoring Agency (Agency responsible for initiating, funding, 
and/or managing service, program, or organization)
                   
* Description (Includes the mission and/or goal(s) of the 
service, program, or organization. Please describe the program 
in a clear and "friendly" manner for the general public.)
                   

Days & Hours of Operation e.g., M-F 9:00 a.m.-5:00 p.m.

Time Zone 
 

Indexing Information

To view a list of terms for a category, select the category 
name link at the left (Audiences, Services, etc.).

Audience(s) 
 
Service(s) 
 
State(s)/ Territory(ies) Served 

Publication(s) 
 
Subject(s) 
 
Special Collections 



Submitter Information

Submitter must provide all required fields below for the 
purpose of validation. The email that you provide below will 
be the one that will receive the email confirmation.

* First Name
* Last Name
  Title
  Phone
* Email

Comments (Optional)

Please provide any additional comments/suggestions about this information collection form, the directory, or EROD website.             

According to the Paperwork Reduction Act of 1995, no persons 
are required to respond to a collection of information unless 
it displays a valid OMB control number. The valid OMB control 
number of this information collection is 1800-0012. The time 
required to complete this information collection is estimated 
to average 1 hour per response for a new submission or 10 
minutes per response for an update or correction, including 
the time to review instructions, search existing data sources, 
gather the data needed, and complete and review the 
information collection. If you have any comments concerning 
the accuracy of the time estimate or suggestions for improving 
this form, please write to: U.S. Department of Education, 
Washington, D.C. 20202-4651. If you have any comments or 
concerns regarding the status of your individual submission of 
this form, write directly to: U.S. Department of Education, 
Office of the Chief Information Officer, Development Services 
Group, Attn: EROD, 400 Maryland Avenue, S.W., Washington, D.C. 
20202-4760. 


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