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Cobb Homeless Alliance General Membership Form
*
1.
I am joining as an:
(Required.)
Individual
Organization
Organization Name
*
2.
Contact Information (required)
(Required.)
Name
Address
Phone
Email
3.
Organizational Information
Organization
Position/Title
Website
*
4.
Sector Represented (Check all that apply)
(Required.)
Nonprofit Homeless Provider
Social Service Provider
Victim Service Provider
Mental Health Agency
Faith-Based Organization
University
Government
Hospital
Business
Affordable Housing Development
Advocate
Public Housing Agency
School District
Organization Serving Veterans
Law Enforcement
Person with Lived Experience
Other (please specify)
5.
What services does your organization provide?
6.
What are topics of interest in the field of homelessness/housing/social services you would like to have discussed/presented by the CoC.
Current Progress,
0 of 6 answered