www.theteenproject.com
Cell Phone Application Brings Shelter Resources to Homeless Youth and Abused Women All Over the Nation. Please complete this brief survey to add your program to our national listing.
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1
. Name of Program
Name of Program
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2
. Street Address
Street Address
*
3
. City
City
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4
. State
State
*
5
. Zip Code (this is imperative for text home program to refer people in your area to your agency)
Zip Code (this is imperative for text home program to refer people in your area to your agency)
*
6
. Phone number to be displayed on cell phone when people text for help in your area
Phone number to be displayed on cell phone when people text for help in your area
7
. Contact Name
Contact Name
*
8
. Contact email
Contact email
9
. Website
Website
*
10
. Type of Program (can be more than one)
Type of Program (can be more than one)
Youth Shelter 0-18
Emancipated Youth 18-24
Sober Living
Domestic Violence
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11
. Genders Served (Primary resident if serving people with children)
Genders Served (Primary resident if serving people with children)
Male
Female
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12
. Ages Served (primary resident if family)
Ages Served (primary resident if family)
0-18
12-18
18-24
18+
Other
13
. If Answered "other" in the last question, please specify here
If Answered "other" in the last question, please specify here
*
14
. Do you serve families or people with children?
Do you serve families or people with children?
Yes
No
*
15
. Brief description of your program describing the services that you provide
Brief description of your program describing the services that you provide
50%
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