Montgomery County Point-in-Time-Count Volunteer Registration Form

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The point in time is an annual survey of homeless persons in Montgomery County who are residing in sheltered and unsheltered environments. This year the count for the unsheltered will be conducted on:
Wednesday night January 25 and Thursday morning January 26 | 9:00 p.m. or 2:00 a.m. approximately

We need help completing the point-in-time survey. Volunteers will receive training with refreshments on Wednesday, January 25th and will be going out in teams to designated locations, where we believe unsheltered homeless persons may be located.

If you are able to volunteer, please register by filling out the registration form: 2017 Homeless Point-in-time Volunteer Registration Form.

Training will be provided on
Wednesday, January 25, 2017 at 7p.m.
1301 Piccard Drive, 1st Floor Conference Rooms A - C.
Rockville, Maryland 20850

If you have any questions, please contact us at HHSPIT@montgomerycountymd.gov

Option 1

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Please click the link or cut and paste to view this 8 minute video. http://pathprogram.samhsa.gov/Resource/View.aspx?id=49498. If you have access to YouTube click the picture below.

After watching the video, please make your commitment to the survey by completing the registration form below.

I am available to attend the training then conduct the survey at the following time: *

ALL volunteers must attend the training on the night of January 25th at 7:30 p.m. at 1301 Piccard Drive, 1st Floor Conference Rooms, Rockville, MD 20850.

I will be a night surveyor (Attend Training at 7:30 PM on the night of the 28th then go out immediately to conduct the survey (9:00 PM - 1:00 AM).

I will be a morning surveyor (Attend Training at 7:30 PM on the night of the 28th then return the morning of the 29th at 4:00 AM to conduct the survey).

I will be a super surveyor (Attend Training at 7:30 PM on the night of the 28th then go out the night of the 29th to conduct the survey AND continue to morning of the 28th).

First Name *

Last Name *

Email Address *

Telephone Number *

Please provide your best number for contact before and on the night of the PIT. Your number will not be shared and will not be used in the future unless specified.

I certify that I am at least 18 years of older. *

Volunteers must be 18 years or older to participate

Option 1

Is this your first time volunteering for Montgomery County's Point-in-Time-Count? *

Please provide a contact person in case of emergency. *

Emergency contact person's home or cell telephone number. *

Another number to reach your Emergency contact (optional)

Do you speak another language? *

Yes

Which language(s) do you speak?

List all languages you are fluent in and would be willing to interpret for.

If yes, are you available to help as an interpreter?

Yes

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1. The point in time is an annual survey and count of homeless persons in Montgomery County who are residing in sheltered and unsheltered environments. These numbers are reported to Congress, State, and Local Government / County Council each year and effects the funding we receive in Montgomery County. The PIT demonstrates trends in our community for additional housing. *

How are the PIT numbers utilized?

Assist with Budget

Determine Housing Need

Report to Local and Federal Government

All of the Above

2. Homelessness is defined as a lack of regular or adequate nighttime residence. A person may be temporarily living either in an emergency shelter, transitional housing, or sleeping in a public or private place not designed for human habitation, such as a bus stop, parking garage, or woods. *

A person evicted from their apartment, is now sleeping on a friend's couch. This person is homeless. True or False

True

False

Things To Remember

Dress for the weather, it will be cold and some locations are in wooded areas. Ensure you have a flashlight and cell phone that is fully charged.

How did you do?

Answers: 1. All of the Above and 2. False (sleeping on a friend's couch is not considered homelessness)

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