INDIANA 211 PARTNERSHIP, INC. MEMORANDUM OF UNDERSTANDING Purpose of Partnership The purpose of the Indiana 211 Partnership, Inc. (IN211) shall be to plan for, implement and oversee a telephone-based information and referral system in Indiana through the use of the 2-1-1 dialing code so that people in Indiana in need of human services have quick referrals to those who provide them, and data is collected to assist communities in assessing needs and allocating resources. (Section I of by-laws) Working Principles 1. IN211 will maximize the strengths of each organization to accomplish collectively what none can accomplish alone. 2. Meeting and communications processes will remain open and inclusive, enabling each partner to participate fully in the development of an Indiana 211 system. Indiana 211 Partnership will provide to Member Partners: 1. Leadership from staff and board in planning and implementing Indiana’s 211 system. 2. Commitment to improvement of quality of I&R service delivery statewide, including linkages between comprehensive and specialized I&R services, served and under-served areas. 3. Development of policies and procedures, advocacy, funding and regulatory strategies. 4. Opportunities to give guidance and feedback through open committee, board and annual meetings. 5. Technical assistance to 211 service providers and regional stakeholders. 6. Regular communications regarding 211 activity. Member Partners will: 1. Seek to involve others within their organizations to support the 211 initiative, broadening the coalition through letters of support, and canvassing membership to identify barriers and build support. 2. Seek to bring resources to the process (financial, human, in-kind, human service update information) to support the initiative, and each partner shall be responsible for bringing representatives to 211 partnership committee, board and annual meetings. 3. Provide feedback to board to ensure timely decision-making to meet partnership deadlines. 4. Agree to air differences within the context of the partnership forums and seek to resolve conflicts within the partnership. As the designated representative of the member organization, I affirm that the organization below seeks membership within the Indiana 211 Partnership. I understand that it is my organization’s responsibility to notify IN211 of any changes in representation and/or contact information. Per the by-laws of the Indiana 211 Partnership, membership is subject to renewal with the approval of the board of directors. _____________________________________ ________________________________ Signed Date _____________________________________ ________________________________ Printed Name Title Note: this memorandum is an expression of the current intent of the parties and does not create any legal obligations and no legal obligations shall be created unless the parties execute a written partnership agreement or other definitive agreement. INDIANA 211 PARTNERSHIP, INC. ORGANIZATION REPRESENTATION AND 2006 MEMBERSHIP DUES Organization’s Name:___________________________________________________________________ Primary Contact / Voting Member Name:__________________________________________________________________________________ Address:_______________________________________________________________________________ City/State/Zip:___________________________________________________________________________ Telephone:_______________________________ Fax:________________________________________ E-mail:__________________________________________________________________________________ Second Contact Name:__________________________________________________________________________________ Address:_______________________________________________________________________________ City/State/Zip:___________________________________________________________________________ Telephone:_________________________________ Fax:______________________________________ E-mail:__________________________________________________________________________________ Organizational Mission/Purpose: ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ To keep communications timely and cost effective, information will be distributed by e-mail. If this will not work for you, please indicate how you prefer being contacted. _______________________________________________________________________________________ ________________________________________________________________________________________ Annual Organizational Membership is $100. Per the by-laws, a general member is defined as follows: General Members. General membership in the Corporation shall be limited to those governmental and non-profit organizations that (i) have as part of their stated mission or purpose providing or supporting the provision of information and referral services or human services; and (ii) have executed a memorandum of understanding with the Corporation or unincorporated association that preceded it. Affiliate Members. Affiliate membership in the Corporation shall be limited to those organizations that, while not eligible to be General Members, have a mission or purpose that encompasses providing or supporting the provision of information and referral services. Please complete this form and mail it with your check by Friday, March 3, 2006 to: Indiana 211 Partnership, Inc. 3901 North Meridian Street, Suite 9 Indianapolis, Indiana 46208-4026 For more information, contact Lucinda Nord, IN211 executive director, at 317.502.8504 or firstname.lastname@example.org or Lora Olive, Communications Coordinator, at 921-7527.
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