Pop-Up PHC 2018 Service Provider Registration
The first Pop-Up Project Homeless Connect of 2018 will be held Tuesday, January 16, 2018 at 1401 North Las Vegas Boulevard in Las Vegas, Nevada from 9:00 am to 3:00 pm. Please join us for this collaborative event that aims to provide essential services to our community members experiencing homelessness. Additional 2018 dates are to be determined.
Service Category
Primary Service to be Provided *
Dates
Additional 2018 dates are to be determined.
Dates of Participation *
Required
Organization
Name of Organization *
Your answer
Contact Person *
Your answer
Contact E-mail *
Your answer
Contact Phone Number *
Your answer
Tables and Chairs
1 table and 2 chairs will be provided unless otherwise specified.
Tables Requested *
Chairs Requested *
Electricity and Internet
We will make every effort to accommodate requests, however, access to electricity and/or internet is not guaranteed.
Will your organization require electricity? *
Will your organization require internet access? *
Other
Will your organization be providing services from a mobile unit? *
Will your organization be providing bus passes for follow-up appointments? *
Provide a brief description of the services your organization will be providing. *
Your answer
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