HOMELESS

Please complete this assessment if you are currently experiencing homelessness.

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* 1. What is your name?

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* 2. How long have you been homeless?

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* 3. What is the main cause of your homelessness?

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* 4. What is your long-term housing goal?

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* 5. What can the Tribe offer to help you achieve your housing goals?

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* 6. Have you used any of the Tribe's Housing programs? Why or why not?

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* 7. If affordable housing became available in the Upper Lake Rancheria, would you be interested?

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* 8. Do you have dependents that are currently affected by your homelessness?

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* 9. Describe your current living situation (where do you stay)?

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* 10. Do you have time to relocate?

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* 11. If yes, what are your plans?

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