PCC/PCP or Foster/Adoption Support Agency Exhibitor Memorandum of Understanding Date(Required) MM slash DD slash YYYY Name of Individual Completing MOU(Required) First Last Name of PCC/PCP or Foster/Adoption Support AgencyAddress PCC/PCP or Foster/Adoption Support Agency(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Counties Your Agency Serve in Kentucky(Required)StatewideAdair CountyAllen CountyAnderson CountyBallard CountyBarren CountyBath CountyBell CountyBoone CountyBourbon CountyBoyd CountyBoyle CountyBracken CountyBreathitt CountyBreckinridge CountyBullitt CountyButler CountyCaldwell CountyCalloway CountyCampbell CountyCarlisle CountyCarroll CountyCarter CountyCasey CountyChristian CountyClark CountyClay CountyClinton CountyCrittenden CountyCumberland CountyDaviess CountyEdmonson CountyElliott CountyEstill CountyFayette CountyFleming CountyFloyd CountyFranklin CountyFulton CountyGallatin CountyGarrard CountyGrant CountyGraves CountyGrayson CountyGreen CountyGreenup CountyHancock CountyHardin CountyHarlan CountyHarrison CountyHart CountyHenderson CountyHenry CountyHickman CountyHopkins CountyJackson CountyJefferson CountyJessamine CountyJohnson CountyKenton CountyKnott CountyKnox CountyLaRue CountyLaurel CountyLawrence CountyLee CountyLeslie CountyLetcher CountyLewis CountyLincoln CountyLivingston CountyLogan CountyLyon CountyMadison CountyMagoffin CountyMarion CountyMarshall CountyMartin CountyMason CountyMcCracken CountyMcCreary CountyMcLean CountyMeade CountyMenifee CountyMercer CountyMetcalfe CountyMonroe CountyMontgomery CountyMorgan CountyMuhlenberg CountyNelson CountyNicholas CountyOhio CountyOldham CountyOwen CountyOwsley CountyPendleton CountyPerry CountyPike CountyPowell CountyPulaski CountyRobertson CountyRockcastle CountyRowan CountyRussell CountyScott CountyShelby CountySimpson CountySpencer CountyTaylor CountyTodd CountyTrigg CountyTrimble CountyUnion CountyWarren CountyWashington CountyWayne CountyWebster CountyWhitley CountyWolfe CountyWoodford CountyIf Multiple Counties (but Not Statewide) List HereName of Individual to Receive Communications from OCA(Required) First Last Email of Individual to Receive Communications from OCA(Required) Phone Number of Individual to Receive Communications from OCA(Required)Memorandum of Understanding Between Orphan Care Alliance & PCC/PCP or Foster/Adoption Agency Printed and Signed on FormConsent(Required) I have read and agree with the OCA Exhibitor MOUWHEREAS, Orphan Care Alliance, Inc. (OCA) is a non-profit entity dedicated to assisting and supporting vulnerable families and children in Kentucky and southern Indiana; and WHEREAS, THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM, an organization focused on support and services around child welfare in Kentucky and southern Indiana who provides volunteer opportunities or provide services to vulnerable families and children; and WHEREAS, OCA holds events throughout the aforementioned region targeted at equipping and mobilizing the faith community to engage in the needs of their local community; and WHEREAS, OCA is willing, ready, and able to provide THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM the opportunity to exhibit at our selected events that are open to the public. Now therefore, the parties agree as follows: THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM understands that OCA has the final decision on allowing THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM to exhibit based on the focus of the event and the opportunities or services provided by THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM. THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM understands that not all events that OCA is involved in are OCA events and OCA does not drive the decisions on exhibitors. THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM is always encouraged to invite others to OCA Events whether or not they exhibit If approved, THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM will: * have the option to have an exhibit table at the event at no charge, * Provide a logo which may be used in slide show presentations to acknowledge THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM even if THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM does not exhibit. THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM MUST agree that they will not “sign up or register” anyone at the event. Instead they will direct interested parties to a centralized registration hosted by OCA where they can select THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM as the organization from which they desire to receive follow up. Failure to comply with this item will sever this agreement and invitation to future OCA Events. OCA will provide all registrations that designate THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM as the organization of choice to THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM within 3 business days of the event. This agreement is considered executed when fully signed by both THE PRINTED & SIGNED PCC/PCP OR FOSTER/ADOPTION SUPPORT AGENCY ON THIS FORM and OCA. Electronic Signature(Required) First Last TitleName of PCC/PCP or Foster/Adoption Support AgencyDate(Required) MM slash DD slash YYYY CAPTCHAUntitled
