Virtual Mobile Legal Unit RequestVirtual Mobile Legal Unit Request Your NameOrganizationAddressEmailPhoneType of OrganizationNon-profit, Nutrition Site, local OFA, etc.?Approximately how many seniors does your organization serve on a weekly basis?Describe your organization's mission, and how bringing CELJ's mobile legal unit to your site furthers that mission?Mark which day(s) of the week and time frame you would like to host the mobile legal unit.Monday morning (9am-12noon)Monday lunch (11am-2pm)Monday afternoon (2pm-5pm)Tuesday morningTuesday lunchTuesday afternoonWednesday morningWednesday lunchWednesday afternoonThursday morningThursday lunchThursday afternoonFriday morningFriday lunchFriday afternoonPlease select all that apply. *Evening and weekend hours are available upon request. Please see below.If you require evening or weekend hours, please describe below.If we provide a flyer, would you be able to advertise (social media, newspaper, website, etc.)? Yes No UnsureIf yes to the above question, briefly explain.How did you hear about us?CommentsThis field is for validation purposes and should be left unchanged.