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2018 Point in Time Volunteer Application!


Thank you for your interest in volunteering with the Big Bend Continuum of Care's 2018 Point in Time count.


* Required

Full Name *
Mailing Address:
Address, city,state,zip code
Phone Number: * 123-456-7890
Alternate Phone: 123-456-7890
Email Address: *

Are you 18 years or older? *

Yes       No
Have you participated in the Point in Time count before? *

Yes       No
Have you ever experienced homelessness?

Yes       No
Do you have a vehicle that you are willing to use during the count?

Yes       No
Are you interested in being a Team Lead? The Team Lead is responsible for promoting team unity, collecting surveys, and distributing supplies.
Yes       No
Which training session will you attend?* Training is required.

Wakulla County: Tuesday, January 16, 2018, 6:00-7:30 pm
      Wakulla  Library 4330 Crawfordville Hwy, Crawfordville, FL 32327     

 Gadsden County: Wednesday, January 17, 2018, 6:00- 7:30 pm
       11 South Calhoun Street, Quincy, Florida 32351

Leon County: Sunday, January 21, 2018, 3:00-5:00 pm
      1200 Church (<= Name of org. located at:) 1200 West Tharpe Street
      Tallahassee, Florida 32303

 In which county (counties) would you like to volunteer?*
Taylor        Gadsden         Franklin        Wakulla         Leon  

For which shift(s) would you like to volunteer?*

Tuesday (Leon, Gadsden or Wakulla County)
6 am - 9 am       10 am - 2 pm         2 pm - 5 pm        6 pm - 9 pm

Wednesday (Leon County)
6 am - 9 am       10 am - 2 pm         2 pm - 5 pm        6 pm - 9 pm

Thursday (Leon County)
6 am - 9 am       10 am - 2 pm         2 pm - 5 pm        6 pm - 9 pm

Would you like to make a donation? You will be contacted for more information about your donation.
Snacks and bottled water
Items to distribute (gloves, socks, blankets/sleeping bags, baby wipes, personal hygiene items, tents, etc.) 
$5 gift cards (fast food, grocery stores, Walmart, Target) for interviees

Thanks for your help!

updated 1-15-18


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