Organizational Membership Application

General Collaborative Membership - Organizational

Organizational Active Level Membership Application

* Indicates required field

Organization Name *

Organizational Mailing Address *

Line 1

Line 2

City

State

Zip Code

Country

Primary Organizational Representative (Required):

Name: *

First

Last

Email Address *

Phone Number *

Most recent TCCoC Meeting attended: *

Secondary Organizational Representative (Optional):

Name: *

First

Last

Email Address: *

Phone Number: *

Most recent TCCoC Meeting attended: *

Please check all that apply to your organization: *

Briefly describe your organization's work addressing homelessness and/or providing services to individuals or families experiencing homelessness: *

What does your organization hope to contribute and/or gain from working with TCCoC? *

Tehama County Continuum of Care's Code of Conduct/Conflict of Interest Policy:
At any time, an issue or matter may come before the Continuum for which a Member may have a conflict of interest, (s)he shall abstain from voting on said issue or matter. The Member may still participate in the discussion if they fully disclose the nature of their conflict of interest and the majority of the Members present vote to allow their participation. Any Member with a conflict of interest may still answer questions posed by another Member during the discussion.

I agree to observe the Tehama County Continuum of Care General Collaborative's Code of Contact/Conflict of Interest Policy. *

Yes

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General Collaborative Membership - Organizational

Organizational Active Level Membership Application

Primary Organizational Representative (Required):

Secondary Organizational Representative (Optional):

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