On this screen, enter contact information for the person you consider head of household for your family.
Homeless?
Are you currently homeless?: This field is mandatory. Select Yes if you do not have a permanent address.
Residential Address
Provide the address where you permanently live.
Street 1
Street 2
City
State
Zip
Mailing Address
Is your mailing address the same as your residential address?: This field is mandatory. Select Yes or No from the drop-down list. If No, provide your Mailing Address. Enter:
Street 1
Street 2
City
State
Zip
Contact Details
Provide phone number(s) where the agency may contact you. Enter phone numbers by entering 3 digits for the area code in the first box and 7 digits for the phone number in the second box. Do not enter dashes or spaces within the boxes. Example: 318 555 4444.
Home Phone Number
Work Phone Number
Cell Phone Number
And / or Other Phone Number
If a phone number is not provided, an error displays saying Warning: You have not provided a phone number. Providing a phone number will help us to contact you if we have any questions or need more information. Please consider adding a phone number. If you do not have a phone number, you can enter the number of a friend or family member who can help us get in contact with you.
Would you like to receive text messages regarding updates and registration?: Check the checkbox (optional) to receive text messages regarding your registration.
Email Address: Enter a complete e-mail address where you may be contacted.
Click Previous to return to the Personal Information screen.
Click Save & Exit to save your place in the registration and return to the home screen.
Click Next to continue.