SurveyMonkey Powered Online Survey

Atlanta CoC Workgroup Membership Form

The Atlanta Continuum of Care (CoC) is a group of direct service providers, government entities, businesses and community stakeholders who promote community-wide commitment to the goal of ending homelessness in the City of Atlanta.

Please complete the information below for workgroup membership consideration.

Question Title

* 1. Contact Information:

First and Last Name

Address

City

State

Zip Code

Email Address

Phone Number

Question Title

* 2. If you are applying to join a workgroup for persons with lived experience (PLE), choose the workgroup based on your age.

Client Advisory (Ages 25+)

Youth Advisory (Ages 18-24)

I am not applying for a PLE workgroup.

Question Title

* 3. Please select which workgroup(s) you are interested in joining. You may select more than one option.

Client Advisory (Must be 25+ and a PLE)

Youth Advisory (Must be 18-24 and a PLE)

Racial Equity