CTN | Housing Partnership Form (Digital Equity Competitive Grant)
Community Tech Network (CTN), a CHUSA partner stakeholder, is leading a Digital Equity Competitive Grant proposal to benefit CHUSA sites, Housing Authorities, city Housing Agencies, Stakeholders, and Nonprofits and is seeking feedback to understand the greater needs of each site interested in participating.  
Email *
Please confirm your interest in partnering on CTN's Digital Equity Competitive grant proposal to provide digital inclusion support services for CHUSA sites, Housing Authorities, city Housing Agencies, and Nonprofits serving in the Housing sector? *
My agency is planning on applying individually for the NTIA Competitive Grant and would like more information on the suggested partnership: *
Organization Name *
If you are a current CHUSA participant, what Tier has your site been placed in? (Currently only Tier 1 & 2 sites have been identified) *
Please select service area category *
What State is the agency headquartered in? *
How long has your agency/site participated in Digital Equity/Digital Inclusion work? *
How many clients/residents does your agency/site serve annually? *
Does your organization agree to signing a Letter of Commitment (template will be provided)?
This is a requirement of the grant.
*
Definition of a UEI:
A UEI is a government-provided number, like a tax ID number, that's used to identify businesses eligible for federal grants, awards and contracts. 
Will your organization be able to provide a UEI # to CTN inside of the Letter of Commitment?
This is a requirement of the grant.
*
Primary Contact Name *
Email *
Phone Number *
Alternate Contact
Alt Contact Email
Alt Contact Phone
Please provide any additional information about your Agency/Community's unique needs that may be beneficial to take into consideration.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Community Tech Network.

Does this form look suspicious? Report