Your Way Home Continuum of Care Membership Form

Membership in the Your Way Home Continuum of Care (CoC) is free and open to any person or organization committed to ending and preventing homelessness in Montgomery County, Pennsylvania. Join today!

All CoC members must agree to uphold Your Way Home's mission to end and prevent homelessness and its Statement of Racial Equity Principles and Values, which can be read here: Statement of Racial Equity Principles and Values.

Affiliate level membership is open to any individual that is committed to ending and preventing homelessness in Montgomery County. Individuals may be residents, people with the lived experience of homelessness, Your Way program participants, and staff or volunteers who work for a nonprofit/faith/community-based organization, business, governmental entity, or school/university.

Affiliate membership benefits include:

Sharing your ideas for improving the Your Way Home Housing Crisis Response System at regularly held community meetings.
Subscribing to the Your Way Home monthly e-newsletter and other special email announcements.
Participating in one or more Your Way Home Advisory or Action Teams teams to inform CoC policies, programs, and partnerships.
Receiving early registration invitations to the Your Way Home Annual Summit and other events.
Meeting other people who care about ending and preventing homelessness in our community.
Creating a stronger unified voice for positive change.

Agency level membership is required for any organization that currently receives funding to deliver Your Way Home services through a contract with the Montgomery County Office of Housing and Community Development. Every contracted agency must identify one staff member or volunteer to serve as its official CoC representative.

Agency members enjoy all of the benefits of affiliate members. In addition, agency members have the following roles and responsibilities:

Electing members of the CoC Governing Board.
Serving on at least one CoC Advisory or Action Team.
Attending at least 75% of required CoC membership meetings, trainings, and events.

Election to the CoC Governing Board, the elected body that votes to approve CoC policy changes and HUD/FEMA grant applications, is open to any affiliate or agency member in good standing through an annual nomination process. A member in good standing has attended at least 50% of CoC general membership meetings and 50% of Advisory or Action Team meetings on which they serve in the past year.

Question Title

* 1. Are you applying to be a Your Way Home CoC Affiliate member (open to all) or an Agency member (a single designated representative of a CoC-funded service provider agency)?

Affiliate member (individual)

Agency member (designated by agency leadership)

Question Title

* 2. Tell us about yourself.

Name *

Organization (if any)

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address *

Phone Number *

Question Title

* 3. Which of the following groups do you represent in Montgomery County? (Check all that apply.)

Affordable Housing Developer

Agency Serving Survivors of Human Trafficking

CoC-Funded Victim Service Provider

CoC-Funded Youth Service Provider

Disability Advocate

Disability Service Organization

Domestic Violence Advocate

EMS/Crisis Response Team(s)

Homeless or Formerly Homeless Person

Hospital

Indian Tribe/Tribal Organization

Law Enforcement

Lesbian, Gay, Bisexual, Transgender (LGBTQ+) Advocate

LGBTQ+ Service Organization

Local Government Staff/Official

Local Jail

Mental Health Service Organization

Mental Illness Advocate

Non-CoC Funded Youth Homeless Organization

Non-CoC Funded Victim Service Provider

Organization led by and serving Black, Brown, Indigenous and other People of Color

Organization led by and serving LGBTQ+ Persons

Organization led by and serving people with disabilities

Public Housing Authority

School Administrator/Homeless Liaison

Street Outreach Team

Substance Abuse Advocate

Substance Abuse Service Organization

Youth Advocate

Youth Service Provider

None of the above

Other (please specify)

Question Title

* 4. On which of the following Your Way Home Advisory or Action Teams would you consider joining? (Check all that apply; Agency members must select at least one.)

Advancing Racial Equity

Community Outreach and Education

Consumer Feedback

Homeless Management Information Systems (HMIS)

Permanent Housing Opportunities

Public Systems of Care Partnerships (e.g., criminal justice, employment, food security, public benefits, etc.)

Regional CoC Partnerships (e.g., Bucks, Chester, Delaware, Lehigh, Philadelphia Counties)

System Performance

Transition Age Youth Experiencing Homelessness

Veterans Experiencing Homelessness

None of the above

Question Title

* 5. Do you require any special accommodations or assistance to participate in CoC meetings? If yes, please specify. If no, please skip to the next Question.

In-Person Meetings

Virtual/Online Meetings

Conference Call/Telephone Meetings

Question Title

* 6. *Membership Acknowledgement. I affirm that for my Your Way Home CoC membership to be in good standing, I must:

1. Uphold Your Way Home's mission to end and prevent homelessness and its Statement of Racial Equity Principles and Values.

2. Attend at least 50% of Your Way Home CoC membership meetings and 50% of Advisory or Action Team meetings on which I serve.

Acknowledged (check this box)

Question Title

* 7. Your Way Home collects and discloses aggregate (not your personal/individual) CoC membership diversity information. Please answer this question if you agree to the inclusion of this information.

What is your gender identity?

Man

Genderqueer or non-binary

Woman

Transgender

Prefer not to answer

Other (please specify)

Question Title

* 8. Your Way Home collects and discloses aggregate (not your personal/individual) CoC membership diversity information. Please answer this question if you agree to the inclusion of this information.

What is your race or ethnicity? (Check one or more.)

Black or African American

White

Native Hawaiian or Other Pacific Islander

Asian or Asian American

Hispanic, Latina/Latino/Latinx, or Spanish Origin

American Indian or Alaskan Native

Prefer not to answer

Other (please specify)

Question Title

* 9. Your Way Home collects and discloses aggregate (not your personal/individual) CoC membership diversity information. Please answer this question if you agree to the inclusion of this information.

Have you ever personally experienced literal homelessness?

Yes

Your Way Home Continuum of Care Membership Form

Question Title

* 1. Are you applying to be a Your Way Home CoC Affiliate member (open to all) or an Agency member (a single designated representative of a CoC-funded service provider agency)?

Question Title

* 2. Tell us about yourself.

Question Title

* 3. Which of the following groups do you represent in Montgomery County? (Check all that apply.)

Question Title

* 4. On which of the following Your Way Home Advisory or Action Teams would you consider joining? (Check all that apply; Agency members must select at least one.)

Question Title

* 5. Do you require any special accommodations or assistance to participate in CoC meetings? If yes, please specify. If no, please skip to the next Question.

Question Title

Question Title

* 7. Your Way Home collects and discloses aggregate (not your personal/individual) CoC membership diversity information. Please answer this question if you agree to the inclusion of this information. What is your gender identity?

Question Title

* 8. Your Way Home collects and discloses aggregate (not your personal/individual) CoC membership diversity information. Please answer this question if you agree to the inclusion of this information. What is your race or ethnicity? (Check one or more.)

Question Title

* 9. Your Way Home collects and discloses aggregate (not your personal/individual) CoC membership diversity information. Please answer this question if you agree to the inclusion of this information. Have you ever personally experienced literal homelessness?

* 7. Your Way Home collects and discloses aggregate (not your personal/individual) CoC membership diversity information. Please answer this question if you agree to the inclusion of this information.

What is your gender identity?

* 8. Your Way Home collects and discloses aggregate (not your personal/individual) CoC membership diversity information. Please answer this question if you agree to the inclusion of this information.

What is your race or ethnicity? (Check one or more.)

* 9. Your Way Home collects and discloses aggregate (not your personal/individual) CoC membership diversity information. Please answer this question if you agree to the inclusion of this information.

Have you ever personally experienced literal homelessness?