NeighborImpact Agency Online App or Service Login Data Submission Form
Please use this form to document online app or service login information for any online sites or services used by you or your department
Your name
First Name
Last Name
Department
Please Select
Child Care Resources
Development
Early Head Start
Energy Assistance
Executive
Facilities
Finance
Food Program
HomeSource
Housing Stabilization
Human Resources
Information Technology
Lending
Representative Payee
Special Projects
Weatherization
Name of app or service
Website URL (if applicable)
Username
Password
Permission level
End user/lowest level
Manager or Supervisor/medium level
Administrator/highest level
Additional comments:
Anything we need to know about accessing or using the app?
Submit
Should be Empty: