Committee for Social Justice Intake form
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Full Legal Name
What is the best way to reach you?
Other (Please explain in question below)
Email (you check regularly)
Other Phone number (perhaps a family or friend's so we have a backup way to reach you)
Please give us an idea of why you are contacting us (Please include: All important information, such as: when, where, who were the parties involved, additional important details)
Were you offered any shelter or social services during the interaction? If so which?
What is your living situation?
If you are living in a shelter, which one?
Do you live in Santa Barbara County?
if Yes, do you plan to continue to live in this area for the next 6 months?
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