2022 Scoring and Ranking Team- Unsheltered NOFO - Interest Form

Please complete this form by Wednesday, August 24. The Scoring and Ranking Team will be trained September 1, 2022. Applications will be available for review September 1-12, with Scoring and Ranking Day September 13, 2022. Please plan for this to be an all-day event.

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* 1. Contact Information

Name

Company

Email Address

Phone Number

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* 2. What is your ethnicity?

Hispanic or Latin(x)

Non-Hispanic or Latin(x)

Refuse to Answer

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* 3. What is your race?

American Indian/Alaska Native or Indigenous

Asian or Asian American

Black, African American or African

Native Hawaiian or Pacific Islander

White

Refuse to Answer

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* 4. Are you 24 years or younger?

Yes

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* 5. What is your gender identity?

Male

Female

A gender other than singularly female or male (e.g., non-binary, genderfluid, agender, culturally specific gender)

Transgender

Questioning

Refuse to Answer

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* 6. Are you a member of the LGBTQ community?

Yes

Refuse to Answer

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* 7. Have you ever experienced homelessness?

Yes

Refuse to Answer

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* 8. If yes, has the most recent experience of homelessness been within the past 7 years (since 2015?)?

Yes

Not Applicable

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* 9. Have you ever participated on a CoC Scoring and Ranking Team?

Yes

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* 10. Are you willing to serve on the Appeals Committee instead of participating in the scoring and ranking process?

Yes

I would prefer to be apart of the scoring and ranking but am willing if needed

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* 11. If approved to participate as a member of the Scoring and Ranking Team you must sign the Conflict of Interest and Confidentiality Agreement.

I acknowledge