Name:	Bellefaire Jewish Children's Bureau
Real Party In Interest:
Type of industry:	medical
Address:	22001 Fairmount Blvd
Address 2:
City:	Shaker Heights
State:	OH
Zip Code:	44118
Contact Person:	Adam Jacobs
Phone:	216-320-8231
E-Mail:	jacobsa@wingspancg.org

III. Brief description of the type of legislation to which the Legislative Agent's engagement relates:
Legislation which will effect the interest of the employer
IV. Categorical listing of principal business or activity of Employer:
-Medical/Hospital/Health Care
V. I am a state employee/officer registering on behalf of my public agency, other than an institution of higher education:
NOT CHECKED