Share your story!
Shelterwell wants to know about your experiences with evictions or unstable housing. This information will help guide Shelterwell in which services to provide as well as assist in efforts to advocate for more resources, better policies, and stronger tenant protections. These stories have made, and will continue to make, an impact on your community. Make your voice heard. 
Sign in to Google to save your progress. Learn more
Have you been evicted? What factor(s) led you to being evicted?
Are you currently at risk of being evicted? What would help keep you in your home?
Yes
Yes, but do not use my name
No
May we share your story with journalists?
May we share your story on social media and newsletters?
May we share your story with your City Council member or State Representative?
Are you willing to tell your story at a City Council meeting/hearing?
Clear selection
Name (required) *
Email Address (optional)
Phone Number (optional)
Address (optional)
Zip Code (required)
Submit
Clear form
Never submit passwords through Google Forms.
GoogleForms
This form was created inside of Brad's Workspace.