2. DCHI Name (if different from above):

3. Contact Information:
    (Contact Person)
    (Address)
    (Phone)
    (E-mail)
    (Organization/DCHI URL)

4. Type of DCHI (personal membership, organization membership,     consortium, federation, other):

5. Mission/Purpose:

6. Personnel directly involved with DCHI operations:
    (Number)
    (Names, titles)

7. Governance Structure
    Board Members (names, titles, institutional affiliations):

    Committees, Advisory Groups, Task Forces, other:

8. Product/Service offered:

9. Relationships with other organizations:
    (Names of organizations)
    (Type of relationship: parent, sponsor, affiliate, member, funder,     other)

10. How did the creation of the DCHI come about?

11. Was a needs assessment conducted prior to establishing operations?       If yes, what were the results?

12. Source of Financial Support:
    (Business model)
    (Financial managment)

13. Sustainability Issues:
    (Problems in achieving)
    (Problems in sustaining)