Please use your browser print function to print this form.

DuPage County Homeless Continuum of Care


Yes, I (we) want to do more to end homelessness in DuPage County!!

 


Name:

Address:

City:

Zip:

Organization:

Phone:

Fax:

Email:

 


   _________________________________________________________

   _________________________________________________________

   _________________________________________________________

   ________________

   _________________________________________________________

   (         ) _______________________

   (         ) _______________________

   _____________________________

 
I am interested in joining the following committes(s):
 
   
   Needs Assessment Committee
 

   Community Outreach Committee
 

   Homeless Prevention
 

   Homeless Management Information System Users Group
 

   Street Count Subcommittee
 

   General Member Only
 




Please return to:
   DuPage County Homeless Continuum of Care
   DuPage County Human Services
   421 N. County Farm Road
   Wheaton, IL 60187

For more information please call:
(630) 407-6600

Return to Continuum Home Page

Last Updated June 16, 2011