Registration Form: Merced County Homeless Count 2018
HOMELESS COUNT: THURSDAY | JANUARY 25, 2018

The Merced City and County Continuum of Care is organizing and implementing the 2018 Merced County Homeless Count Survey, which will take place on January 25th.

We are currently looking for individuals to conduct the Count and Survey and would like to make you aware of this important need in the ongoing effort to end homelessness in Merced County.

The Department of Housing and Urban Development (HUD) mandates that every jurisdiction that receives federal funding conduct a Homeless Count Survey. The Merced City and County Continuum of Care (Merced CoC) conducts this count every year in January.

Counters will be sent in teams of 2-6 on THURSDAY, JANUARY 25, in the early morning from:
6:00AM to 8:00AM

EACH COUNTER IS REQUIRED TO ATTEND:
An Orientation Meeting - Homeless Count Instructions
There will be a choice of two Orientation meetings from 6:00PM to 7:00PM

WEDNESDAY, JANUARY 17, 2018 at 6:00PM | CITY OF MERCED CIVIC CENTER
678 W 18TH STREET | SAM PIPES ROOM

OR

THURSDAY, JANUARY 18, 2018 at 6:00PM | CITY OF MERCED CIVIC CENTER
678 W 18TH STREET | SAM PIPES ROOM

PLEASE NOTE:
If you are currently experiencing homelessness/formerly homeless and wish to volunteer for the count, a MANDATORY MEETING is SCHEDULED for:

WEDNESDAY, JANUARY 24, 2018 at 6:00PM | CITY OF MERCED CIVIC CENTER
678 W 18TH STREET | SAM PIPES ROOM

Please enter your personal information below and answer a few questions that will help us organize the different teams that will be out on THURSDAY | JANUARY 25, 2018.

First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Phone Number *
(209) # # # - # # # #
Your answer
Organization (your affiliation, if any) *
Your answer
Would you like to participate as a counter/surveyor for the 2018 Merced County Homeless Count *
Have you participated in a previous Homeless Count in Merced County? *
Where in Merced County would you like to volunteer? (Choose one) *
Would you like to serve as a Key Person Team Leader? *
Do you own or have access to a vehicle on the day of the count (January 25th, 2018)?
Do you speak Spanish fluently? (Able to read and converse) *
Will you be 18 years or older on the day of the count? (January 25th, 2018) *
How did you hear about this volunteer oppoortunity? *
Are you experiencing homelessness/formerly homeless? *
Which ORIENTATION will you be able to attend? *
REMEMBER
Orientations will take place at City of Merced Civic Center | 678 W 18th Street |Sam Pipes Room at 6PM
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms