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HCH Grantees Update
RequiredRequired Question(s)
Progress: 
 
Required 1.

Does your entry need correction?
You may check the current information we have for your organization here.

No, it is complete, current and accurate. (Fill in required fields below & click submit)
Yes, please make the corrections indicated below. (Fill in new information where appropriate and click submit)
Required 2.

Individual Submitting form:

 

50 characters left.
Required 3.

Submitter's Telephone:

 

50 characters left.
Required 4.

Submitter's Email:

 

350 characters left.
Required 5.

Grantee Organization Name:

 

350 characters left.
Required 6.

UDS Number

 

50 characters left.
Required 7.

Mailing Address:

 

350 characters left.
Required 8.

City:

 

50 characters left.
Required 9.

State:

 

50 characters left.
Required 10.

Zip:

 

50 characters left.
11.

Fax:

 

50 characters left.
12.

Web Site:

 

50 characters left.
Required 13.

Director or Executive Officer:

 

50 characters left.
Required 14.

Phone:

 

50 characters left.
Required 15.

Email:

 

50 characters left.
Required 16.

Medical Director:

 

50 characters left.
Required 17.

Phone:

 

50 characters left.
Required 18.

Email:

 

50 characters left.
Required 19.

HCH Coordinator:

 

50 characters left.
Required 20.

Phone:

 

50 characters left.
Required 21.

Email:

 

50 characters left.
22.

Estimated number of homeless people in this city on an annual basis:

 

50 characters left.
23.

Number of homeless clients served annually by grantee and subcontractors:

 

50 characters left.
24.

Subcontractors or Sub-recipients:

 

1000 characters left.

If your HC Clinic or Project information is different from the grantee above, please fill in the next section.  If it is the same, please skip to field 35

 
25.

HCH Clinic/Project Name:

 

50 characters left.
26.

HCH Clinic/Project Name (if different from grantee name):

 

50 characters left.
27.

HCH Clinic/Project street address:

 

50 characters left.
28.

HCH Clinic/Project City:

 

50 characters left.
29.

HCH Clinic/Project State:

 

50 characters left.
30.

HCH Clinic/Project Zip:

 

50 characters left.
31.

HCH Clinic/Project telephone:

 

50 characters left.
32.

HCH Clinic/Project fax:

 

50 characters left.
33.

HCH Clinic/Project e-mail:

 

50 characters left.
34.

HCH Clinic/Project Website:

 

50 characters left.
35.

Brief Introduction:

 

1000 characters left.
36.

Linkages:

 

1000 characters left.