•1,000+ Clients Served•5+ Years Serving Maryland Communities•100% Free To Eligible Medicaid Members•4 Core Service Areas — Housing, Health, Financial Wellness & Workforce

Partners

Become A Partner

Thank You For Your Interest In Partnering With Affordable Living & Supportive Services (ALSS). Please Complete The Form Below So We Can Learn More About Your Organization And Explore Meaningful Ways To Collaborate In Supporting Individuals And Families.

1. Organization Information

Organization / Business Name

Organization Type

Website

Address

City

State

ZIP Code

2. Primary Contact Information

Contact Person Name

Title / Position

Email Address

Phone Number

Preferred Method Of Contact

EmailPhoneEither

3. Partnership Interest

Please Check All That Apply.

Community Resource ReferralsFinancial Support Or SponsorshipDonations Of Goods Or ServicesEmployment Or Workforce OpportunitiesHousing Or Relocation SupportEducational Or Training OpportunitiesHealth, Wellness, Or Counseling ResourcesTransportation AssistanceVolunteer SupportEvents Or Community Outreach

Other

4. Services, Resources, Or Support Offered

Please Describe The Services, Resources, Discounts, Donations, Programs, Or Other Support Your Organization May Be Able To Provide To ALSS Participants Or The Community.

5. Collaboration Opportunities

How Would You Like To Collaborate With ALSS?

Become A Listed Community ResourceAccept Referrals From ALSSParticipate In Community EventsProvide Workshops, Classes, Or Informational SessionsOffer Special Rates Or Services To Eligible ParticipantsDevelop A Formal Partnership Or Memorandum Of Understanding

Other

6. Additional Information

Service Area / Counties Served

Availability Or Hours Of Service

Eligibility Requirements Or RestrictionsAdditional Comments Or Questions

7. Acknowledgment And Submission

By Submitting This Form, I Confirm That The Information Provided Is Accurate To The Best Of My Knowledge. I Understand That Submitting This Form Expresses Interest In Partnership And Does Not Guarantee Approval Or Establish A Contractual Relationship With Affordable Living & Supportive Services.Authorized Representative Name (Typed Signature)

Affordable Living & Supportive Services

Serving Maryland Communities With Housing, Health, And Financial Stability Programs.

443-888-1712 · admin-team@affordablelivingservices.com