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HomeMy WebLinkAbout2019 FMCoC Membership Application FINAL 12.16.18 Fresno Madera Continuum of Care (FMCoC) 2019 General Membership Application and Annual Agreement The Fresno Madera Continuum of Care (FMCoC) invites nonprofit service providers, government entities, businesses, groups and individuals to join in the effort to end homelessness in our community by becoming a member of the FMCOC. The FMCoC serves as the Continuum of Care for the cities of Fresno, Clovis, Madera and all the municipalities within the Fresno and Madera Counties. We are dedicated to increasing the awareness of the problems of people who are homeless and to the development and strategies to create permanent solutions to homelessness in our community. In the coming year, the FMCoC will carry out its mission by promoting and implementing strategies to end homelessness. General Membership: General membership shall consist of homeless supportive and housing service providers, homeless prevention service-agencies, homeless individuals, interested community members, public & nonprofit service providers, local government and local government systems-service entities, businesses, and faith based organizations. The FMCoC members will share information, receive notices of CoC activities, trainings, HUD homeless funding, and will be eligible to receive FMCoC participant letters-confirming their role in the CoC coordinated regional efforts. General Membership Fees Membership in FMCOC is determined by organization size (including individual membership): Members will self select their category. The annual membership fee is due no later than Friday, January 11, 2019, for the 2019 year. Non-Government Organizations Fee Schedule: City and County Government Agency Fee Schedule: Annual Budget Dues Population Size Dues Up to $100,000 $100/year 500,000+ $5,000/year $100,001 - $300,000 $200/year 100,000 – 499,000 $2,500/year $301,000 - $500,000 $300/year Up top 99,999 $1,000/year $500,001 - $800,000 $400/year $801,000 – 1,500,000 $500/year Individual Membership Fee Schedule: Over $1,500,0000 $650/year Individual Member $100/year General Members of the FMCOC are eligible to:  Apply for new and/or renewal funding from the U.S. Department of Housing and Urban Development (HUD).  Apply for new and/or renewal funding from the City and Counties of Fresno and Madera during 2019.  Submit applications to outside organizations with the supportive documentation and letters from the FMCoC, of belonging to the regional effort addressing and ending homelessness. To join the FMCoC, or to renew your membership, please complete the enclosed application signed by the organization’s authorized representative, and return with a check for membership fees made payable to the Central Valley Community Foundation, addressed to: Fresno Madera Continuum of Care C/O: Fresno EOC, Michelle L. Tutunjian 2336 Calaveras Street, Fresno, CA 93721 1 Please Check Application Status: Please Check General Membership Affiliation: City and County Government Agency Membership Application Non-Government Organization Membership Application Individual Membership Application MEMBER NAME: ADMINISTRATIVE ADDRESS: CITY: STATE: ZIP: FAX: PHONE: WEBSITE: Agency Designation: Government: 501(c)(3): for profit: other (explain): Continuum of Care Please identify one primary and one alternate person to serves as the FMCoC Director and Alternate Director representing your agency. These persons will be the official representatives documenting your agency attendance and as recipients of agenda’s, notices, etc. These individual(s) will have the following responsibilities: 1) Regularly attend FMCoC’s monthly membership meetings; and 2) Communicate back to their own organization, as appropriate, information that is shared at the membership meetings, events, and/or through email communications. PRIMARY DIRECTOR CONTACT NAME: Check here if same as administrative address above ADDRESS: CITY: STATE: ZIP: FAX: PHONE: E-MAIL (please print clearly: ALTERNATE DIRECTOR CONTACT NAME: Check here if same as administrative address above ADDRESS: CITY: STATE: ZIP: FAX: PHONE: E-MAIL (please print clearly: Organization Information  Please note: Due to the large number of individuals and organizations we communicate with, FMCoC uses email as the primary/sole contact. By giving your email address here you agree to have it added to this service. Be assured that your email address will only be used to send you information pertaining to FMCoC and/or activates beneficial to your clients. 2 Please help us to get to know you better by checking below the populations your organization serves and the services you provide. Primary /Target Service/Area of Interest: Fresno County Madera County City of Clovis City of Fresno City of Madera Populations served (check all that apply) Seriously Mentally Ill Substance Abusers Veterans Persons with HIV/AIDS Survivors of Domestic Violence Youth Chronically Homeless (A “chronically homeless” individual is someone who has experienced homelessness for a year or longer, or who has experienced at least four episodes of homelessness in the last three years and has a disabling condition. A family with an adult member who meets this description would also be considered chronically homeless.) Other populations not included above: Services Provided (check all that apply) Rapid Rehousing/ Homeless Prevention Outreach Supportive Services Housing Mortgage Assistance Street Outreach Case Management Emergency Rental Assistance Mobile Clinic Life Skills Transitional Utilities Assistance Alcohol & Drug Abuse Permanent Counseling/Advocacy Mental Health Counseling Legal Assistance Healthcare HIV/AIDS Education Employment Child Care Transportation Additional services provided not included in this list: SIGNATURE: DATE: (Organization’s Authorized Representative) PRINTED NAME: TITLE OF PERSON SIGNING: