The Road Home Membership Candidate Application

2. 

4. Value Statement for the COC Membership Application
   The Continuum of Care’s guiding principles include a commitment to exercising racial equity, diversity and inclusion – with shared power and vision in all decisions and practices by this body and all funding entities – to create an equitable service delivery system to prevent and eliminate homelessness in Pierce County. <br><br> The Continuum of Care values these practices in the homeless system because people of color are much more likely to experience homelessness in Pierce County than those who are White. Race influences homelessness. This is a result of centuries of structural racism that have historically excluded oppressed people, particularly Black and Native Americans, from equal access to housing, community supports and opportunities for economic mobility.

   The Continuum of Care’s guiding principles include a commitment to exercising racial equity, diversity and inclusion – with shared power and vision in all decisions and practices by this body and all funding entities – to create an equitable service delivery system to prevent and eliminate homelessness in Pierce County.
   
   The Continuum of Care values these practices in the homeless system because people of color are much more likely to experience homelessness in Pierce County than those who are White. Race influences homelessness. This is a result of centuries of structural racism that have historically excluded oppressed people, particularly Black and Native Americans, from equal access to housing, community supports and opportunities for economic mobility.

6. Membership Candidate Application
   Please complete all required fields below.

   Please complete all required fields below.

7. About The Road Home
   Click to learn more about the Continuum of Care.

9. First name*

10. Last name*

12. Preferred Pronouns

14. Email*

15. Phone Number*

17. Address 1*

19. Address 2

21. City*

22. State*

23. Zip*

25. CoC Seats*

    The CoC has seats that are required by HUD, WA State Dept of Commerce, and the local entities. Please select which seat(s) you would be qualified to fill (SELECT ALL THAT APPLY).

    1. Affordable Housing Developer
    2. CoC Funded Victim Service Organization
    3. CoC Funded Youth Homeless Organization
    4. Coordinated Entry
    5. Department of Justice
    6. Disability Advocates
    7. Disability Service Organization
    8. EMT/Crisis Response Team(s)
    9. Hospital(s)
    10. Law Enforcement

    1. LGBT Advocates
    2. Local Jail(s)
    3. Mental Health Service Organization
    4. Mental Illness Advocates
    5. Non-CoC Funded Homeless Organization
    6. Non-CoC Funded Youth Homeless Organization
    7. School Admin/Homeless Liaison(s)
    8. Substance Use Service Organization
    9. Supportive Services for Veteran Families
    10. Tacoma/Pierce County Coalition to End Homelessness
29. If you have affiliated with a group or organization as a volunteer, board or staff member, please tell who you worked with and in what capacity (this will not qualify or disqualify you from becoming a member of the CoC).

31. Describe your interest in and/or experience with preventing and ending homelessness in Pierce County.

33. What is your definition of racial equity?

35. Give us an example of when a situation brought racial equity concerns to you and then explain what you did as a result?

37. How have you been invested in actions of Equity?

39. Describe how you will share with other participants in the CoC your expertise in the position for which you are applying.

41. What else would you like for us to know about you?

43. What days or times of the day/evening are you available?

47. Commitment Statement
    Commitment Statement By my signature below, if selected to The Road Home Committee, I understand I am committing to attend the regularly scheduled CoC Committee meetings for the duration of my term. I further commit to uphold the value statement and ethics of this CoC.

    Commitment Statement By my signature below, if selected to The Road Home Committee, I understand I am committing to attend the regularly scheduled CoC Committee meetings for the duration of my term. I further commit to uphold the value statement and ethics of this CoC.

49. Signature*

50. Date*
    Date

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52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit Submit and Print

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