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* 1. Name

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* 2. Name of your organization / affiliation with housing and homeless services

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* 3. Job Title

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* 4. Have you or your organization engaged in work to look at how race plays a role in homelessness?

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* 5. Are you or your organization interested in commencing in this work?

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* 6. Can you commit to attending both full day convenings on Thursday October 17th and Friday October 18th?

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* 7. Do you know another organization or community advocate/leader in your community who is actively engaged in racial equity work related to housing and homelessness who you think we should invite?

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* 8. If yes to question 7, please list your reference's name, email and affiliation with racial equity, housing and homeless service delivery.

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