HCH2019 Consumer Agreement Form

Applications are due February 28, 2019.

Consumer Agreement

As a part of this application for a Consumer Conference Subsidy for the 2019 National Health Care for the Homeless Conference and Symposium in Washington, D.C., from May 22 to 25, 2019, I agree to the following:

  1. I agree that there are certain expectations that come with this Consumer Conference Subsidy. These include, but are not limited to: full participation in the Conference, sobriety during meetings, respectful physical appearance, and participation in all required meetings;
  2. If any part of the Conference is a challenge for me at any time, I agree to contact my mentor, a member of the NCAB Steering Committee, a NCAB Regional Representative, or a Council staff person for assistance.
  3. I understand that I must be a member of NCAB to be eligible for the Consumer Conference Subsidy.
    1. Join online for free here; 
  4. I understand that I am responsible for spending per diem funds appropriately;
  5. I understand that I must attend the NCAB Orientation on Wednesday, May 22, 2019 from 5:00 to 7:00 p.m. Eastern Time; 
  6. I understand that I must attend the NCAB Business Meeting on Friday, May 24, 2019 from 7:00 to 8:15 a.m. Eastern Time; 
  7. I understand that I am expected to attend at least one consumer-oriented workshop per day, and that I am expected to complete a brief questionnaire about my experiences at the Conference;
  8. I understand that I am expected to read the Consumer Information Packet that is sent out with the Subsidy notifications and reach out with any questions before the Conference;
  9. If I am selected for the Subsidy, I agree to attend an informational call about the Conference and the Subsidy with the organizational representative on Monday, April 8, 2019 at 3:00 p.m. Eastern Time. 

2019 Conference Consumer Agreement

  • First time attendees are paired with a mentor to support them before and during the conference. If you are a first time attendee, can we share your information with your NCAB mentor? *Please note that this will allow your mentor to understand that you meet the criteria for a consumer, meaning you have experienced homelessness and used services at an HCH site.
  • The National Consumer Advisory Board works to engage and support local consumers and consumer engagement; we have Regional Representatives that specifically work to support local consumer engagement at HCH projects, do you want your information shared with your Regional Representive? *Please note that this will allow your Regional Representatives to understand that you meet the criteria for a consumer, meaning you have experienced homelessness and used services at an HCH site
  • Please enter name and the last four digits of your social security number to certify that you agree to uphold the requirements for the subsidy if you are chosen.