Dairyland Housing Coalition Point In Time Street Count Volunteer Sign Up
Wednesday, January 28, 2026
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
example@example.com
Are you representing an Agency or are you a Community Member?
*
Agency
Community Member
Other
Which Agency?
*
Would you prefer a walking route or driving route?
*
Walking Route
Driving Route
Either Route
Other
Are you willing to drive?
*
Yes
No
Maybe
Are you comfortable riding with others?
Yes
No
Other
Preferred Area
*
Buffalo County
Eau Claire County
Jackson County
Trempealeau County
Any County
Counties Preference
Buffalo County
Trempealeau County
Jackson County
Previous Point In Time Street Count Experience:
*
Yes
No
Have you been recently trained for administering Narcan?
Yes
No
Yes, but it's been a while. I could use a refresher.
Other
Other: Narcan
Are you comfortable performing CPR if needed?
Yes
No
Maybe
Other: CPR
Preferred Team Members: We will do our best to accommodate requests. You will be in a group with at least one person that has previous PIT experience. Groups are typically 3-4 people.
Any other information that you want to share with us:
Submit
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