CITY ADMINISTRATOR’S OFFICE HOMELESSNESS DIVISION
VOLUNTEER & ENGAGEMENT
REGISTRATION FORM

Encampment management is only one facet of the City of Oakland’s plan to address homelessness. Our strategy is to engage, empower, and educate the community concerning this issue. We cannot do it alone. With the community's dedicated service and support, we can make a difference. Our goal is to galvanize resources and consensus to achieve the same goal for Oaklanders experiencing homelessness: Public health and safety that honors personal dignity while respecting public spaces and personal property. Working together, we can significantly reduce homelessness, beautify the community, and manage encampments. We are grateful for your willingness to partner. Your commitment and service are crucial as we work together to impact homelessness in Oakland.

Please complete the form below. If you have further questions or need more information, please email homelessness@oaklandca.gov

PLEASE PRINT.

Question Title

* 1. CONTACT INFORMATION

Name (First Name)

Name (Last Name)

Organization / Business

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Website

Question Title

* 2. ARE YOU INTERESTED IN VOLUNTEERING?

Yes

Undecided

Question Title

* 3. PLEASE CHECK ALL THE AREAS WHERE YOU WOULD LIKE TO SERVE

Host Community Meetings

Clean up and Beautifications

Neighborhood outreach

Advisory Group

Serve on Homelessness Commission

Donate Good and services

Internship

Special project

Philanthropy

Pastoral Care/ Counseling

Crisis and Emergency Response

Employee/ Employer Giving Community Service Program

Other (please specify)

Question Title

* 4. ARE YOU INTERESTED IN PROVIDING A PRODUCT/SERVICE?

Yes

Undecided

Question Title

* 5. IF YOU ARE INTERESTED IN PROVIDING A PRODUCT OR SERVICE,
PLEASE CHECK ALL APPLICABLE BOXES.

Meals/Catering

Childcare

Accounting

Cash/Gift Cards

Clothing

Hotel Vouchers

Children’s items (clothing, diapers, toys, books, art supplies)

Essential personal items (Blankets/Socks/Shoes)

Technology (used cellphones and other electronics)

Makeovers (hair styling, barbering)

Personal care items (soap/wipes/toothbrushes/toothpaste/vaseline)

Other - please specify. (Maximum Response at 70 characters).

Question Title

* 6. FOR EMPLOYEE GIVING PROGRAM CONTRIBUTIONS

Business Name

Address

City/Town

State/Province

ZIP/Postal Code

Country

Employee Giving Program Name

Web address

Program Lead Name

Phone Number

Question Title

* 7. PLEASE CHECK APPLICABLE CONTRIBUTION CATEGORIES

Employee Volunteer Hours

Monetary Donations

In-kind Contributions

Technical Assistance

Executive on Loan

Other - please specify. (Maximum Response at 70 characters).

Question Title

* 8. ADDITIONAL QUESTIONS/COMMENTS: (Maximum Response at 150 characters)

Thank you taking the time to complete this form.

Your support and commitment to the City of Oakland is valued and greatly appreciated.

100% of survey complete.

CITY ADMINISTRATOR’S OFFICE HOMELESSNESS DIVISION VOLUNTEER & ENGAGEMENTREGISTRATION FORM

Question Title

* 1. CONTACT INFORMATION

Question Title

* 2. ARE YOU INTERESTED IN VOLUNTEERING?

Question Title

* 3. PLEASE CHECK ALL THE AREAS WHERE YOU WOULD LIKE TO SERVE

Question Title

* 4. ARE YOU INTERESTED IN PROVIDING A PRODUCT/SERVICE?

Question Title

* 5. IF YOU ARE INTERESTED IN PROVIDING A PRODUCT OR SERVICE,PLEASE CHECK ALL APPLICABLE BOXES.

Question Title

* 6. FOR EMPLOYEE GIVING PROGRAM CONTRIBUTIONS

Question Title

* 7. PLEASE CHECK APPLICABLE CONTRIBUTION CATEGORIES

Question Title

* 8. ADDITIONAL QUESTIONS/COMMENTS: (Maximum Response at 150 characters)

CITY ADMINISTRATOR’S OFFICE HOMELESSNESS DIVISION
VOLUNTEER & ENGAGEMENT
REGISTRATION FORM

* 5. IF YOU ARE INTERESTED IN PROVIDING A PRODUCT OR SERVICE,
PLEASE CHECK ALL APPLICABLE BOXES.