Pop-Up PHC 2018 Service Provider Registration
Pop-Up Project Homeless Connect will be held on the third Tuesday of the month. Please join us for this collaborative event that aims to provide essential services to our community members experiencing homelessness.

February 20, 2018 - 10 am to 2 pm at The Center (401 South Maryland Parkway) - REGISTRATION CLOSED
March 20, 2018 - Times and location are to be determined.

Family Connect will take the place of Pop-Up PHC for the month of April. Family Connect is scheduled for April 11, 2018 from 2:00 pm to 7:00 pm at Cambridge Recreation Center. For more information or to register to provide services, visit nevadahomelessalliance.org/familyconnect

Service Category *
Select the category that is most closely associated with the services your organization will be providing.
Dates of Participation *
Additional 2018 dates are to be determined. Please continue to check back.
Required
Organization *
Your answer
Contact Person *
Your answer
Contact E-mail *
Your answer
Contact Phone Number *
Your answer
Tables Requested *
Chairs Requested *
Electricity *
Will your organization require electricity? *We will make every effort to accommodate requests, however, access to electricity is not guaranteed.
Internet *
Will your organization require internet access? *We will make every effort to accommodate requests, however, access to internet is not guaranteed.
Mobile Unit *
Will your organization be providing services from a mobile unit?
Bus Passes *
Will your organization be providing bus passes for follow-up appointments?
Service Description *
Provide a brief description of the services your organization will be providing. *Your description will be published in a service directory to be distributed to participants and providers at the event.
Your answer
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