Sheboygan County Point in Time Sign-Up Form for January 2019
Event Timing: Wednesday, January 23rd at 11:00 pm
Various 3-hour shifts are available between 11:00 pm on 01/23 to 6:00 am on Thursday, January 24th, 2019
Sheboygan County
The service-based count ends on Friday, 01/24 at 5:00 pm
Contact LCAP in Sheboygan at 920.803.6991
Email address *
Your name (first & last) *
Your answer
All participants require a criminal background check to be conducted. Please provide your date of birth: *
Your answer
Your phone number (on the night of the count) *
Your answer
Organization, if applicable. *
Your answer
Mailing Address *
Your answer
Which shift do you prefer? (You can select if you could help) *
Required
If you are signing up as a group, please provide the names of your teammates (up to 4 people per group)
Your answer
I have participated in the PIT previously? *
I am willing to be a driver during the count? *
If I am needed to drive during the count, I can provide proof of valid car insurance? *
Please indicate which training you are able to attend: *
How did you hear about the PIT Homeless Count? *
Your answer
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