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FL-511 Elected Seats - Leadership Council Member Application

If you are a Continuum of Care (CoC) Member in good standing and are interested in being considered for an Elected Seat on the CoC Leadership Council, please complete this application in its entirety. Thank you for your commitment to enhancing the work of the CoC and its leadership efforts.

APPLICANT INFORMATION

Please tell us about yourself.

What type of CoC Membership do you hold now?
Individual
Organization
Which of the following counties do you live in?
Escambia
Santa Rosa
Other
What counties do you represent?
Which board seat are you most interested in being considered for?
Person with lived experience of homelessness
Affordable Housing Developer or Provider
Healthcare System or Provider
Homeless Service Provider
Law Enforcement
Organizations specific to serving or representing persons with disabilities
Organization dedicated to advancing equity in marginalized communities
Workforce Development
Faith-based Community Representative
General Seat (open to any relevant individual or organization, including nonprofit homeless 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, organizations that serve homeless and form
Other

You should select the seat for which you have the most experience and representation.

Please list your 2nd choice of elected seat. This will help us ensure applicants are considered for more than one seat if many qualified candidates apply.
Person with lived experience of homelessness
Affordable Housing Developer or Provider
Healthcare System or Provider
Homeless Service Provider
Law Enforcement
Organizations specific to serving or representing persons with disabilities
Organization dedicated to advancing equity in marginalized communities
Workforce Development
Faith-based Community Representative
General Seat (open to any relevant individual or organization, including nonprofit homeless 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, organizations that serve homeless and form
Other

You should select the seat for which you have the most experience and representation.

DEMOGRAPHIC INFORMATION

The following questions are optional for you to answer. Your answers will help us ensure we have diversity and accurate representation among our CoC Leadership Council.

Preferred Pronouns
He/Him
She/Her
They/Them
Prefer not to answer
Other
Do you have lived experience of homelessness, either currently or in the past?
Yes
No
Prefer not to answer
Which primary race do you identify as?
White
Black/African American/African
Asian/Asian American
American Indian/Alaska Native/Indigenous
Middle Eastern/North African
Native Hawaiian/Pacific Islander
Multiple Races
Prefer not to answer
Do you identify as Hispanic or Latina, Latino, or Latine?
Yes
No
Prefer not to answer
What gender do you identify as?
Woman
Man
Non-Binary
Transgender
Culturally Specific Identity (e.g., Two-Spirit)
Questioning
Another, different gender
Prefer not to answer
Which of the following age groups do you personally represent?
18-24 years of age
25-24 years of age
35-44 years of age
45-54 years of age
55-64 years of age
65+ years of age
Prefer not to answer
Do you identify as having a disabling condition?
Yes
No
Prefer not to answer

Disabling conditions include physical disability, chronic health condition, HIV/AIDS, mental health condition, developmental disability, problematic alcohol and/or drug use, etc.

AFFIRMATION OF UNDERSTANDING AND COMMITMENT

I have read and understand the CoC Governance Charter and understand the role and responsibilities of the CoC Leadership Council.
I affirm my commitment to meeting CoC Leadership Council expectations including:

NARRATIVE

This section will help the nominating committee learn about your interests and experience with leading strategic planning efforts for addressing homelessness. 

If elected to the CoC Leadership Council would you prefer to serve a 2 year or 3 year term?
2-year
3-year

ATTACHMENTS

In this section, you will attach the required documentation that must be included with your application.

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