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If you are an organization or group dedicated to helping people experiencing or at risk of homelessness in Pinellas County, please complete this form so that your program's information can be included in the virtual Pinellas Homeless Resource Guide. Please note that requests are not guaranteed.
Organization Information
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Organization Information
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Information about the organization and individual submitting Pinellas Resource Guide information
1) Organization
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2) Name
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3) Phone
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4) Email
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5) Are you a Continuum of Care (CoC) member?
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Yes, I am an individual member
Yes, my organization is a member
No, but I would like more information
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Status of Resource Guide Entries
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Status of Resource Guide Entries
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Please indicate if current program information is accurate, requires updates, or should be removed, or if new programs should be included.
6) Do any entries require updating?
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NO: All information for my program(s) is still accurate
YES: Multiple entries for my program(s) must be updated
YES: A single entry for my program must be updated
ADD: Add 1 program to this guide
ADD: Add multiple programs to this guide
REMOVE: Delete 1 of my programs from this guide
REMOVE: Delete all of my programs from this guide
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7) Program(s) to be Removed from Resource Guide
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Please provide information about the program(s) you would like removed from the Pinellas Homeless Resource Guide.
New or Updated Program Information
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New or Updated Program Information
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Requests to update or add program information can be completed by 1) entering program information into the box in question # 8, OR 2) answering survey questions 9-15b. Please note that providers may CHOOSE EITHER METHOD and do not need to complete questions 8 and 9-15b.
Option 1: Written Entries
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Option 1: Written Entries
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Please include separate entries for each program in bullet point format: Organization / Program Name; Phone Number(s); Website; Address(es); Hours; Eligible Recipients (everyone, specific zip codes / populations, etc.); Documentation Requirements (ID, bill, paystub, etc.); Program Description; Additional Information.
8) New or Updated Program Information
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Option 2: Update Via Survey
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Option 2: Update Via Survey
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If you prefer, program information can be added or updated by answering questions 9-15b below, which provide prompts about populations served, available services, etc. Please note that if updating multiple entries via survey, multiple forms must be completed. Please also note that this section is not required if information was provided in the text box above.
9) Program Name
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10) Program Phone Number
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11) Program Website
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12) Program Address(es)
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13) Program Hours of Operation / Schedule
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14) Populations Served by Program
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Everyone
Adults
Families
LGBTQ+
Men
Persons with Disabilities
Seniors
Survivors of Domestic Violence
Veterans
Women and Children
Women
Youths Under 12
Youths Under 18
Youths Under 25
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14a) Other Populations Served by Program
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15) Services Offered by Program
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Childcare
Clothing
Domestic Violence Survivor Support
Education
Employment
Ex-Offender Re-Entry Assistance
Financial Resources
Food Pantries
Food: Supplemental Food Assistance (Food Stamps, etc.)
Healthcare
Healthcare: Dental or Vision Health
Healthcare: Medical Respite / Post-Hospital Care
Healthcare: Mental Health
Healthcare: Substance Abuse Treatment
Housing: Emergency Shelter
Housing: Temporary and Permanent Housing Assistance
Hygiene Items
IDs (Driver's License, Social Security, Voter Registration)
Income: SSI, SSDI, Unemployment, etc.
Legal Assistance
Mail Services
Other
Parenting
Pregnancy and Infant Care
Transportation
Transportation: Bus Passes
Transportation: DMV Services
Travelers
Veterans' Services
Women, Infants, and Children (WIC) Nutrition
Youth Services
Youth Services: Transition from Foster Care
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15a) Other Services Offered by Program
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Additional Information
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Additional Information
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16) Additional Information, Comments, or Requests
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Supporting Documentation and / or Questions
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Supporting Documentation and / or Questions
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To ask questions or share supporting documents, such as program flyers, please email VKelly@HLAPinellas.org and / or MRobinson@HLAPinellas.org.