Project Setup Form

Please complete the following form for all new projects. Please make sure you have the following project information prior to completion: Grant / Funding Information, Grant Identifier, Bed Inventory Information, and any services if applicable.

Organization / Agency Name:

Victim Services Provider (VSP)

Please check the box if you are a VSP. A VSP is defined as a private nonprofit organization whose primary mission is to provide services to victims of domestic violence, dating violence, sexual assault, or stalking. A VSP is a designation at the agency level, not the project level.

Name of Person Requesting:

Provide First and Last Name

Phone Number

Project Contact Phone Number

Email Address

Project Contact Email

Project Description:

Provide a brief note about client eligibility. This information would be detailed in the grant agreement for this project.

Street Address:

Use the Organization address if the project has no physical address.

City

Select or enter value

Geocode:

Select or enter value

Operating Start Date

Project Type (Choose One)

Select or enter value

Target Population:

Select or enter value

Housing Type

Select or enter value

HMIS Participating Project:

Select or enter value

Skip Inventory Section

Due to the Project Type, Inventory is not required. Please advance to the next section titled Funding Information.

Inventory Information

Please complete the inventory information below. If you have more than two types of inventory to report please check the box more inventory.

Inventory Start Date:

Household Type:

Select or enter value

Inventory Type

Select or enter value

Total Unit Inventory

Household Type 2

Select or enter value

Inventory Type 2

Select or enter value

Total Bed Inventory 2

Total Unit Inventory 2

Household Type 3

Select or enter value

Inventory Type 3

Select or enter value

Total Bed Inventory 3

Total Unit Inventory 3

Household Type 4

Select or enter value

Inventory Type 4

Select or enter value

Total Bed Inventory 4

Total Unit Inventory 4

Provider Grant Type

Select or enter value

Grant Identifier

This is the Grant or Contract number.

Services

Please list the Services that you would like to track. If more services are needed please check the box "More Services Needed".

Services

Provide a list of services that need to be tracked or entered.

More Services Needed

Custom Assessment / Questions

If you require any custom assessments or questions please check the box below and upload a copy of the assessment or custom questions.

Custom Assessment

Check the box if you require any custom assessments.

Custom Assessment Upload

Please upload a copy of any custom assessments

Drag and drop files here or

Send me a copy of my responses