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* 1. What is the name of your agency?

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* 2. Describe how your organization collaborates with the McKinney-Vento local educational authorities and school districts.
Give examples of how your organization collaborates with local liaisons, state coordinators, school districts, early childhood programs, youth education providers and other educational partners to assure the provision of homelessness and educational services.

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* 3. Please list the name and contact information for the designated staff person at your agency who is responsible for ensuring that participants understand their educational rights, assist children/youth in enrolling in school, and make connections to services.

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* 4. Please check any of the following that your agency has.

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* 5. Please list the names of the mainstream employment organizations where you refer your tenants. These are organizations that provide job readiness, job training, and/or employment opportunities for all individuals and not exclusively for homeless individuals (e.g. Labor Ready). Please describe the referral process and the relationship your agency has with these organizations

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* 6. Please provide the name of your local Workforce Development Board.

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* 7. Describe how you coordinate services with your local Workforce Investment Board.

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* 8. Does your agency have a written agreement demonstrating a partnership with a state or local workforce development board that includes prioritized access to employment opportunities or co-enrollment in workforce and homeless assistance programs for people experiencing homelessness?

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* 9. Does your agency have a written agreement demonstrating a partnership with a local education or training organization that includes prioritized access to education and training opportunities for people experiencing homelessness?

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* 10. How does your agency promote partnerships and access to employment opportunities with private employers and private employment organizations, such as holding job fairs, outreach to employers, and partnering with staffing agencies?

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* 11. Describe how your organization facilitates informal employment opportunities for program participants and people experiencing homelessness (e.g., babysitting, housekeeping, food delivery). How is your agency working with public and private organizations to provide meaningful education and training, on-the-job training, internships and employment opportunities for residents for program participants?

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* 12. Describe how your agency works with organizations to create volunteer opportunities for program participants.

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* 13. How does your agency work to create opportunities for civic participation (town hall mtgs, mtg with public officials, etc)?

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* 14. Does your agency have incentives for employment and volunteering? If yes, please describe

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* 15. Describe how your agency collaborates with healthcare organizations to assist program participants with enrolling in health insurance.

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* 16. Describe how your agency provides assistance with the effective utilization of Medicaid and other benefits (such as SNAP, TANF).

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* 17. Has your agency identified strategies to reduce racial disparities in the homeless services we provide?  If yes,  what are they?

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