Sign Up for the CT 2020 Point in Time Count

Your basic info First Name* Last Name* Please select the description that best describes you:* If you are a Legislator, Mayor, or first selectman please provide a secondary contact we can reach you through (name, email, and phone). Email* What is the best phone number to reach you at? This phone number will be used as contact information to reach you if need be the night of the PIT Count, so please provide a mobile phone number. (PLEASE NOTE this example of the format required: 8885551234)* If you work for a social work organization/police department, or were elected by a town/city/district, then please specify them here:

Your profile Have you ever worked/volunteered with people experiencing homelessness? Do you have a vehicle you'd be willing to use for canvasing the night of the PIT Count? Are you a previous CT PIT Count Volunteer? Can you please list any languages outside of English that you are fluent in? Would you be willing to share with us who is your employer? Employers can be a valuable source for additional help with PIT. Are you participating in the count as an individual, or would you like to participate as part of a group? If you are hoping to volunteer with family/friends, please choose a team name and have them use the same name when they register - this will help us to pair you up for the count!

Deployment Center Please select from the dropdown menu the region you would MOST PREFER to volunteer for the night of PIT.* Please check off below every other region you would be willing to volunteer to canvas. * Unless notified you will be reporting to the count area of your first preference. Thank you for your flexibility.

Emergency Contact While we do not expect issues, we ask that volunteers identify an emergency contact. Emergency Contact Name* Contact Phone Number (PLEASE NOTE this example of the format required: 8885551234)*

Additional Information If you have any additional information to add, please do so here: (500 characters or less)