Lake County Community Resource Guide

  Agency Information Form


Your agency provides valuable services to the residents of Lake County.In an effort to provide information and referral resources to the residents of Lake County, we are updating our information.Would you please take a minute to complete the following information about each program your agency administers?Thank you!

Organization/Agency Name (required)

Is this Org/Agency a Non-Profit?  
Program Name

Phone #

Scope of Services Provided
Be specific!

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Contact Name and Title (required)

email (required)

Fax #

County (or "National")






ZIP Code



Hours of operation (i.e., "M-F, 8:00am-5:00pm")

Ages served

Fee/Cost to Client

What does your agency need from a client in order to provide services? (i.e., Picture ID, Passport, etc.)

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Languages spoken


What proven researched-based programs, models, or strategies are utilized in the services you provide?

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What resources is your agency in need of?
Example: Volunteers, etc.

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Be Free Lake reserves the right to edit or exclude any submissions made.


Please submit your completed form,

 or print it out and ...

mail to: Be Free Lake, P.O. Box 64, Yalaha FL 34797.


If you have any questions, please donít hesitate to call Be Free Lake at 352.383.2099.Thank you!