2010 Membership Directory

1. Default Section

Question Title

* 1. Basic information about the organization.

Company: *

Address: *

Address 2:

City/Town: *

State: *

ZIP: *

Email Address:

Phone Number: *

Question Title

* 2. If applicable, please indicate your web address.

Question Title

* 3. Please provide agency's mission statement.

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* 4. Does your organization provide services to people who are homeless or at-risk of becoming homeless?

Yes

Not sure

Question Title

* 5. What type of funding does your organization receive?

City of Detroit ESG or CDBG

City of Detroit, other

HUD McKinney Vento (SHP, S+C, etc)

MSHDA Homeless Assistance Funding

MSHDA, other

Private Donations/Foundations

Other (please specify)

Question Title

* 6. Which homeless subpopulations (if any) does your organization serve?(Check all that apply)

Seriously Mentally Ill

Substance Abusers

Veterans

People with HIV/AIDS

Survivors of Domestic Violence

Youth (under 18)

Chronically Homeless (A chronically homeless person is an unaccompanied disabled individual who has been continuously homeless for a year or more or has had four episodes of homelessness in the past three years.)

None

Other (please specify)

Question Title

* 7. What type of housing program does your organization provide?

Permanent Supportive Housing

Transitional Housing

Emergency Shelter(families)

Emergency Shelter (singles)

Supportive Service only program

None

Other (please specify)

Question Title

* 8. What services does your organization provide? (check all that apply)

Alcohol & Drug Abuse

Case Management

Child Care

Counseling/Advocacy

Education

Employment

Health Care

HIV/AIDS

Law Enforcement

Legal Assistance

Life Skills

Mental Health

Mobile Clinic

Mortgage Assistance

Rental Assistance

Street Outreach

Transportation

Utilities Assistance

Not Applicable (N/A)

Other (please specify)

Question Title

* 9. Briefly describe your organization’s programs and services. (include days/hours of services,and eligible population)
Example: Youth Outreach Program-food hygiene items, clothing and guidance for youth living on the street up to age 18 or 22 if homeless prior to turning 18. M-F 8 am-4 pm

Question Title

* 1. Basic information about the organization.

Question Title

* 2. If applicable, please indicate your web address.

Question Title

* 3. Please provide agency's mission statement.

Question Title

* 4. Does your organization provide services to people who are homeless or at-risk of becoming homeless?

Question Title

* 5. What type of funding does your organization receive?

Question Title

* 6. Which homeless subpopulations (if any) does your organization serve?(Check all that apply)

Question Title

* 7. What type of housing program does your organization provide?

Question Title

* 8. What services does your organization provide? (check all that apply)

Question Title

* 9. Briefly describe your organization’s programs and services. (include days/hours of services,and eligible population)Example: Youth Outreach Program-food hygiene items, clothing and guidance for youth living on the street up to age 18 or 22 if homeless prior to turning 18. M-F 8 am-4 pm

* 9. Briefly describe your organization’s programs and services. (include days/hours of services,and eligible population)
Example: Youth Outreach Program-food hygiene items, clothing and guidance for youth living on the street up to age 18 or 22 if homeless prior to turning 18. M-F 8 am-4 pm