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:*
Legislator
An outreach worker, or affiliated with a housing agency
Mayor or first selectman
Town social worker
Police Officer
Municipal Agent
None of the above describes me, but I still want to volunteer with PIT.
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?
Yes
No
Do you have a vehicle you'd be willing to use for canvasing the night of the PIT Count?
Yes
No
Are you a previous CT PIT Count Volunteer?
Yes
No
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?
Coming by yourself
Part of a group of friends/family
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.*
Bridgeport (9 pm-1 am, Tuesday, 1/21/20 , )
Bristol (5-7 am, Wednesday, 1/22/20 , )
Danbury (7-11 pm, Tuesday, 1/21/20 , )
Hartford (5-7 am, Wednesday, 1/22/20 , )
Hartford Suburbs (5-7 am, Wednesday, 1/22/20 , )
Litchfield (7-11 pm, Tuesday, 1/21/20 , )
Meriden (7-11 pm, Tuesday, 1/21/20 , )
Middlesex (7-11 pm, Tuesday, 1/21/20 , )
New Britain (5-7 am, Wednesday, 1/22/20 , )
New Haven (4-7 am, Wednesday, 1/22/20 , )
New Haven (North & South) (7-11 pm, Tuesday, 1/21/20 , )
New Haven (West) (7-11 pm, Tuesday, 1/21/20 , )
Norwalk (7-11 pm, Tuesday, 1/21/20 , )
Norwich-New London (7-11 pm, Tuesday, 1/21/20 , )
Stamford-Greenwich (9 pm-1 am, Tuesday, 1/21/20 141 Franklin Street Stamford , CT)
Waterbury (7-11 pm, Tuesday, 1/21/20 , )
Windham (7-11 pm, Tuesday, 1/21/20 , )
Please check off below every other region you would be willing to volunteer to canvas.
Bridgeport
Bristol
Danbury
Hartford
Hartford Suburbs
Litchfield
Meriden
Middlesex
New Britain
New Haven
New Haven (North & South)
New Haven (West)
Norwalk
Norwich-New London
Stamford-Greenwich
Waterbury
Windham
* 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)
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