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Lived Experience Housing Steering Committee (LEHSC) Application
Interested in serving on the LEHSC Board? Please fill out this application to the best of your ability. For questions, please contact [to be filled in]
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* Indicates required question
Name
*
Your answer
Pronouns
*
she/her
they/them
he/him
no pronouns (name preferred)
fae/fem
prefer not to say
Other:
Required
Email Address:
*
Your answer
Phone Number
*
Your answer
Gender
Non - binary
Woman
Man
Other:
Do you hold an Indigenous or Native gender?
Yes
No
Maybe
Other:
Clear selection
Are you transgender?
Yes
No
Maybe
Other:
Clear selection
What is your race?
*
American Indian/Alaskan Native
Asian
African American
Indigenous/First Peoples
Latine
Middle Eastern/North African
European/White
Native Hawaiian/Pacific Islander
Prefer not to say
Other:
Required
Do you reside in Thurston County?
*
Yes
No
Other:
Have you ever been houseless? (living on the street, living in a shelter, couch surfing, living somewhere not meant for human habitation)
*
Yes
No
Other:
What is your current housing status?
Formerly Houseless
Living in Shelter
Living in a supportive living place
Rent/own where you live
Living with friends/family/etc
Other:
What lived experiences do you bring to the group?
Your answer
What changes would you like to make for the homeless community as a LEHSC member?
Your answer
Are there any barriers in attending meetings?
Your answer
Do you have any food allergies or dietary needs?
Your answer
Is there anyone who supported you in filling out this application? Is there any one in Thurston County's Homeless Response Network who you feel would be a resource for you as a LEHSC member?
Your answer
Anything else that you'd like to add?
Your answer
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