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2013 Santa Monica Homeless Count

Dear Volunteer,

Thank you for your interest in participating in our 2013 Homeless Count.

The count will take place on the evening of Wednesday, January 30th from 10:30pm to 2:30am at a location to be determined.

Please take a moment to complete the following questionnaire. If you would like to be teamed up with specific people, please arrive and check-in together as a group. Each person must register to volunteer separately. We will do our best to accommodate your request but cannot guarantee placements.

First name:

   

Last name:

   

Your Primary Phone Number:

   

Organization (if applicable):

   

Your Email Address:

   
 
  How did you hear about this event?
   
 

Have you participated in a Homeless Count before?

                  

Will you need any special accomodations?

 

Do you have any restrictions that prevent you from walking long distances?

            

Do you have a car you would be willing to use for the count?

              

Would you be willing to be a team captain?

                 
    
   
    
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1685 Main St., Santa Monica, CA 90401 · (310) 458-8411 · TTY (310) 917-6626
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