Mendocino County - LMS Registration Form
Name
(Required)
First
Last
Email
(Required)
Your Phone Number (Mobile Phone Preferred)
(Required)
Have you had HMIS access in Mendocino in the past?
(Required)
Yes
No
Organization Name
(Required)
Please Choose an Organization
-- MY ORGANIZATION IS NOT LISTED (May delay approval) --
CDC COMMUNITY DEVELOPMENT COMMISSION OF MENDOCINO COUNTY
FB CITY OF FORT BRAGG
FSP FORD STREET PROJECT
MCAVHN CARE AND PREVENTION NETWORK
MCHC MENDOCINO COAST HOSPITALITY CENTER
MCHC Street Outreach Program
MCHCL MENDOCINO COMMUNITY HEALTH CLINIC
MCHSCOC MENDOCINO COUNTY HOMELESS SERVICES CONTINUUM OF CARE
MCSS MENDOCINO COUNTY DEPARTMENT OF SOCIAL SERVICES
MCYP MENDOCINO COUNTY YOUTH PROJECT
NCIHA NORTHERN CIRCLE INDIAN HOUSING AUTHORITY
NCO NORTH COAST OPPORTUNITIES
NF NATION'S FINEST
RCHDC RURAL COMMUNITIES HOUSING DEVELOPMENT CORPORATION
RCS REDWOOD COMMUNITY SERVICES
Organization Name (Other)
Job Title
(Required)
Supervisor’s Name
(Required)
Supervisor's Email Address
(Required)
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