HALO Resource Support Survey & Interest Form

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Are you an organization or agency serving youth in need? HALO is looking for feedback from you!

In an effort to extend our reach and help support likeminded organizations also fighting to end youth homelessness, HALO is looking for your feedback on resources and supplies your organization is in need of or could utilize for youth in your care.

Please fill out the information below according to your organizations interest, needs and supported youth. Organizations that complete the survey and note they are interested in receiving free supplies and support from HALO will be contacted by HALO Chief Program Officer, Carly Schultze, within 2 weeks of submission, to learn more about how we can collaborate.

Organization Name: *

Organization Point of Contact: Please include name, title and contact information *

Organization Location:

Could your organization and/or the youth you serve benefit from additional support in resource items (hygiene items, food supply, cold weather gear, etc) or creative outlets, such as art supplies and created lesson plans? *

No, we currently have the appropriate amount of resources needed for our youth.

Yes, we could use more support in resources such as hygiene, food and cold weather items.

Yes, we could use more support regarding creative outlets for our youth.

Yes, we could use more support in both areas.

Required

Age Range of Youth Served:

0-4 years

5-12 years

13-18 years

18+

Number of youth your organization serves annually:

Our organization could use a donation of the selected materials on a _____________ basis.

Monthly

Quarterly

Yearly

Other:

Clear selection

Thank you for your feedback! We appreciate the work you do for youth experiencing homelessness and look forward to working more together.

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