Workshop Registration Form
   
If you need assistance completing this form, please call Erie Neighborhood House at (312) 666-3430 or Spanish Coalition for Housing at (773) 342-7575
     
 
   Available Workshops * 
Contact Information
First Name * Last Name *    
Are you homeless? * Age Range *    
Address 1 * Address 2 City *
State * Zip *    
Phone (# Only) Email    
Phone Reason Email Reason    
Background
Primary Language *
Do you need a translator? * Employment Status *
CHA Program of Interest (select at least one)
 
 
 
 
 
 
Reasonable Accommodations
 
 
 

Register Other Guests

Register additional guests
First Name *Last Name *Are you homeless? *Living with You *Address 1 *Address 2City *State *Zip *PhoneEmailPrimary Language *Translator *Options
 

Continue to Confirmation