Resources & Resiliency Digital Education Program Registration Form
First Name *
Your answer
Last Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Residence (you must be a resident of a shelter or transitional housing program to register) *
Your answer
Best phone number to reach you *
Your answer
Can you receive texts at this number? *
How would you rate your computer skills on a scale from 1 to 5 where 1 is "No skills at all" and 5 is "Very highly skilled? *
No skills at all
Very highly skilled
Which session are you registering for? *
Required
Please note that completing this form does not guarantee you a place in the program. Someone from LSH will contact you to confirm your eligibility and set up a time for you to come to orientation.
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