HMIS Project Set-Up

Organization Name *

Contact Person *

Email *

Desired Project Name *

Description of Project *

Project Type *

Will this project provide rental assistance? *

Did this funding originate through the federal government? *

If yes, what type of funding?

Funding *

If Local or Other Funding:

If this project has a local or other funding source (not federally funded), please specify the name of the grantee or funding source.

Funding ID/Grant Identifier *

This number should be within your grant agreement.

Operating Start Date *

Operating End Date *

Site Address (Location of project operations) *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Does this project have beds/units? If so, how many? *

The number of bed and units this project is required to provide.

HMIS Project Set-Up Request Form