Coalition Membership Application

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Membership in the HLC is open to all stakeholders in Central Oregon, including nonprofit homeless assistance providers, victim service providers, faith-based organizations, governments, businesses, advocates, public housing agencies, school districts, social service providers, mental health agencies, hospitals, universities, affordable housing developers, law enforcement, veterans service organizations, and homeless or formerly homeless individuals. Each member (association or individual) of the Coalition has a voice on important community matters, including the opportunity to provide input on CoC decisions by participating in HLC committees and workgroups.

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E-pasta adrese *

Applicant is *

Part of an Organization (direct service provider)

Applying as an Individual

Applying as Business

Applying as faith-community/ church

Citas:

Name of Agency/Entity/Organization or Individual *

Name of Voting Person for Organization (one person only)

Mailing Address *

Phone Number *

Organizations/individuals interested in becoming a member of the HLC affirm by checking each box that they: *

live or work in Deschutes, Crook, Jefferson Counties or within the Confederated Tribes of Warm Springs

Work, for pay or otherwise, to provide, facilitate, or support homeless services

are committed to be an active member of the Homeless Leadership Coalition

are committed to the vision, goals, objectives, and strategies that have been and/or will be decided by the HLC membership

acknowledge the contributions and expectations of the other members of the HLC, and of NeighborImpact, including the completion of the Continuum of Care Collaborative Application, coordination of meetings, newsletters, information and data sharing, and inclusivity as evidenced by a commitment to equity and diversity. 3

Jāaizpilda obligāti

FOR ORGANIZATIONS. Organizations interested in becoming a member of the HLC commit to the following acts of partnership and collaboration. Checking each box signifies your agreement with the following.

Meaningful language access (i.e., translating marketing materials and documents; provide language assistance while providing services)

A practice of equal access and non-discrimination. Provide services to all eligible persons, regardless of race, color, national origin, religion, sex, age, familial status, disability, actual or perceived sexual orientation, gender identity, marital status, height, or weight

Recommend and recruit at least one representative to participate in membership meetings and on at least one committee of interest (Ex.support and engage in the Point in Time Count planning and implementation)

Proactively engage and collaborate with the Homeless Leadership Coalition when concerns or barriers regarding those experiencing homelessness arise

Refer individuals and families who contact their organization/agency and who are homeless or at risk of homelessness to local service providers

Provide the CoC with updated and accurate information about program capacity, service delivery and relevant programmatic changes

Respond to requests for data to the maximum extent possible (based on privacy, etc)

Participate in the completion of the CoC’s required activities such as the consolidated application process or the Point in Time count as requested

FOR INDIVIDUALS. Individuals interested in becoming a member of the HLC commit to the following acts of partnership and collaboration. Checking each box signifies your agreement with the following.

Participate in membership meetings and/or committees

Proactively engage and collaborate with the Homeless Leadership Coalition when concerns or barriers regarding those experiencing homelessness arise

Refer individuals and families who contact their organization/agency and who are homeless or at risk of homelessness to local service providers

Participate in the completion of the CoC’s required activities such as the consolidated application process or the Point in Time count as requested

For businesses and faith communities: Those interested in becoming a member of the HLC commit to the following acts of partnership and collaboration. Checking each box signifies your agreement with the following.

Participate in membership meetings and/or committees as available and interests align

Proactively engage and collaborate with the Homeless Leadership Coalition when concerns, oppportunities or barriers regarding those experiencing homelessness arise

Refer individuals and families who contact their organization/agency and who are homeless or at risk of homelessness to local service providers

Promote the work of the HLC and its member entitites

As general evidence of our/my commitment to the HLC, we agree to *

Promote community-wide commitment to employ best practices to end homelessness in Central Oregon

Promote access to and effective utilization of programs by individuals and families experiencing homelessness

Optimize self-sufficiency among individuals and families who experience homelessness by referring to partner agencies and resources

Commit to partnership, collaboration and coordination

Recommend and recruit at least one organization representative to participate in membership meetings or view meeting recordings and seek to participate in committees or workgroups of interest

Actively participate in Point-In-Time Count yearly and Housing Inventory Count if applicabale (may not apply to all members)

Proactively engage and collaborate with the Homeless Leadership Coalition and its member entities when concerns or barriers regarding those experiencing homelessness arise

Review the newsletter for updates and important information

Jāaizpilda obligāti

The HLC strives to operate through consensus-based decision making, designed to focus on common goals while recognizing that each organization and individual has its own unique goals that they may choose to pursue independently. Checking each box signifies your agreement with the following. *

HLC members are free to take individual positions that may be different than the Coalition position but must not claim either directly or through innuendo that they are representing the HLC.

HLC members have a fundamental belief that we can accomplish more together than apart.

HLC members shall respect one another and diverse viewpoints.

HLC members intentionally promote efforts to work together in an environment of trust, transparency, and collaboration for the benefit of shared outcomes.

Jāaizpilda obligāti

HLC membership dues are based on a sliding scale, reviewed annually, and approved by the Board. Membership dues are collected annually by October 15th. Fees may be waived for persons or at the discretion of the CoC members. Individuals or organizations interested in a fee waiver must contact info@cohomeless.org to make the request, must provide a rationale for the need of a fee waiver, and must be available to participate in a workgroup or other CoC activity in exchange for the fee waiver. Select the category that best represents your organization or yourself. Please mail your payment via check or money order to Homeless Leadership Coalition c/o NeighborImpact 20310 Empire Ave., Ste. A100Bend, OR 97703 . Thank you. *

Organizations with $500,000 budget or more ($250/year)

Small businesses or organizations - budget up to $499,999 ($75/year)

Faith-based partners (Churches or congregations) ($50/year)

Individuals or Families ($25/year)

Membership dues waiver needed. A dues waiver is avaialble for formerly unhoused individuals or those with an economic hardship ($0/year) email info@cohomeless.org to request

FOR ORGANIZATIONS providing direct services to individuals experiencing homelessness, please list up to 2 alternate contacts for voting purposes in the event we are unable to reach you. Please provide name and email.

Please indicate topics of interest that you would like to hear about over the next year. *

FOR ORGANIZATIONS providing direct services: Please attest whether you have made or will make the following HLC promoted and sponsored trainings available to your staff/volunteers.

Equal Access, Equal Opportunity & Non-Discrimination

Fair Housing

De-escalation or crisis response

Addressing Needs of Survivors of Domestic Violence, Dating Violence, Sexual Assault, and Stalking

Addressing needs of victims of human trafficking

Training on accessing mainstream benefits such as SSDI/SSI, SNAP, WIC, TANF, Oregon Health Plan, unemployment insurance, veterans benefits

Child Abuse Prevention

Suicide Prevention

FOR ORGANIZATIONS providing direct services: Please indicate the geographic reach of your programs and services.

Confederated Tribes of Warm Springs

Bend

Redmond

Sisters

La Pine

Madras

Prineville

Citas:

FOR ORGANIZATIONS providing direct service please indicate the total number of members of your team who have lived experience of homelessness (previous stays in shelters or living unsheltered):

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