Submit a Find a Provider Entry Use this form to submit a new listings only for CHHSM's Find a Provider network. Listings should reflect the community of a CHHSM member ministry in good standing. Future updates to this listing will be made through CHHSM's annual membership update process. Community ProfileThe following fields will appear on the organization's Find a Provider profile on the CHHSM website. Community Name*Service Provided*Select OneAffordable HousingPrimary and Acute Health CarePublic Grant Making InstitutionServices to Children, Youth and FamiliesServices to Older AdultsServices to Persons with Disabilities (not affordable housing)Transitional/Shelter Care HousingUCC Conference*Select OneCalifornia, Nevada NorthernCalifornia, Nevada SouthernCalvin Synod ConferenceCentral AtlanticCentral PacificFloridaHawaiiHeartlandIllinoisIllinois SouthIndiana-KentuckyIowaKansas-OklahomaMaineMichiganMinnesotaMissouri Mid-SouthMontana-Northern WyomingNebraskaNew HampshireNew YorkNorthern PlainsPacific NorthwestPenn CentralPenn NortheastPenn WestPennsylvania SoutheastRocky MountainSouth CentralSouth DakotaSoutheastSouthernSouthern New EnglandSouthwestVermontWisconsinWebsite* Phone*FaxAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code In-Kind and Financial GiftsCommunities may list up to 5 wish list items (e.g., in-kind donations) as well as email addresses where in-kind and financial gift inquiries may be directed. This information will be displayed on the organization's Find a Provider listing.Wish List Item #1Wish List Item #2Wish List Item #3Wish List Item #4Wish List Item #5Contact for Volunteer or In-Kind Donations Contact for Financial Donations Contact InformationComplete the following fields as a representative of the organization completing this form.Name* First Last Role*Email* Phone*CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.