Non Residential Shelter Study
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Please complete the information below if you are interested in having your organization participate in the 2010 national domestic violence study.

1. Your name

Your name

2. Organization

Organization

3. City/Town

City/Town

4. Email

5. Phone

Phone

6. Please check all that apply

Please check all that apply I am the director or have the authority to commit my organization to participate in the study

I am an advocate interested in bringing information about this study to my program

I participated in the shelter study in 2008 and am familiar with how these studies work

I volunteer to be the contact person for the study

I volunteer to be a back-up contact person for the study

7. If you are the director or other person authorized to sign up your program for the national study, please help us figure out how many surveys to send you, so that you’ll have enough for the 1st month.

The surveys are for program participants (clients) who are not in shelter, not in immediate crisis, and have been to your program at least once.

If you are the director or other person authorized to sign up your program for the national study, please help us figure out how many surveys to send you, so that you’ll have enough for the 1st month. The surveys are for program participants (clients) who are not in shelter, not in immediate crisis, and have been to your program at least once. English
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Non Residential Shelter Study Exit this survey

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Non Residential Shelter Study
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