Memorandum of Understanding Template
This document serves as a Memorandum of Understanding (MOU) between:  <Our Agency Name> AND <Community Organization Name>
General Purpose: To provide < Our Agency Name> with 

This collaboration supports improved communication with at-risk populations for emergency preparedness planning and information dissemination during emergencies.
Agreement:
<Community Organization Name> agrees to:
1.	
2.	
3.	
<Our Agency Name> agrees to:
1.	
2.	
3.	
If <Community Organization Name> staff  have any questions that cannot be answered through <Community Organization Name>, they should contact <Our Agency Contact Person> at <Our Agency Email> <Phone Number>.
This document is a statement of understanding and is not intended to create binding or legal obligations with either party.
Agreed to and accepted by:
Date _______Name _________________________________Title _________________________
Name of Community Agency _____________________________________________________
Address ______________________________________________________________________
City ______________________________________ ST ______________ ZIP _______________
Telephone Number _____________________________________

Date _______Name _________________________________Title _________________________
Name of Our Agency ___________________________________________________________
Address ______________________________________________________________________
City ______________________________________ ST ______________ ZIP _______________
Telephone Number _____________________________________