2023 Homeless Resource Day Interest Survey

Please fill out the following survey to express your interest in the 2023 Homeless Resource Day. The event is scheduled, Thursday, October 19, 2023 at the Activity Center at Bohrer Park, Gaithersburg, Maryland.

Feel free to share the flyer and form. More information will follow.

If you have questions, contact us at HHSHRD@montgomerycountymd.gov. Thank you.

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* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. Which organization, agency or department do you represent?

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* 5. Is this your first time participating in Homeless Resource Day?

Yes

No

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* 6. Would you like to receive additional information about the 2023 Homeless Resource Day?

Yes

No

Please remove me from this distribution list.

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* 7. If, yes, please let us know how you plan to participate in Homeless Resource Day. (Check all that apply)

Sponsor

Service provider

Donor

Volunteer

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* 8. Please share any comments here.