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* 1. Organization Name 

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* 2. Point of Contact First and Last Name 

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* 3. Point of Contact Title

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* 4. Point of Contact Email 

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* 5. Will you be applying to host Fellow(s) in the Housing Justice Program Cohort II

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* 6. Will you be applying to host an attorney Fellow, if yes how many?

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* 7. Will you be applying to host an organizer Fellow, if yes how many?

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* 8. Geographic Service Area (where Fellow would be serving)?

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* 9. Can we share this information with other Host Organizations applying to host Fellows in the Housing Justice Program for the purposes of facilitating cooperative and symbiotic proposals?
 

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