Skip survey header

Safe Shelter Collaborative: Application

Thank you for taking the time to complete this application. The information you share helps us understand if the Safe Shelter Collaborative is a good fit for your organization. We'll be in touch soon after receiving your information.
1. What is your organization type? *This question is required.
3. Your contact information *This question is required.
This question requires a valid email address.
4. What is your organization's mailing address?  *This question is required.
6. Does your organization provide:  *This question is required.
7. What population does your agency currently serve?  *This question is required.
  • * This question is required.
8. If your agency provides sheltering services, how many total beds do you have?  *This question is required.
9. Are you interested in using the Safe Shelter Collaborative to
  • Locate available shelter space with other agencies in my area*
Note: This service is currently active New Jersey, TexasColorado and Northern California. If you are not located in one of these areas, you may still select "Yes" and we will send you updates as we expand this service to new regions. We are actively adding new regions. *This question is required.
10. Are you interested in using the Safe Shelter Collaborative to:
  •  Help source funding for hotel rooms when a shelter bed is not available.
Note: If you choose to use this service, your agency name will be included in the list of shelters visible in the SafeNight app that potential donors can select from to receive alerts for hotel funding. This service is only available to organizations that are able to receive tax exempt donations. *This question is required.
12. Who will be the primary Safe Shelter Collaborative administrator in your organization? *This question is required.
13. Who should we contact with questions about your organization's account if the administrator is out of the office?  *This question is required.