Apply to Granite Leaders

Thank you for your interest in Granite Leaders! The current application cycle is now closed.

Instructions

The application process for Granite Leaders allows us to collect some basic information regarding prospective participants. Following the submission of your application, we will contact you within five business days to share additional details about the program and to provide you with an opportunity to ask any questions that you may have. The application process is meant to provide prospective participants with the opportunity to fully understand the purpose, requirements, and benefits of Granite Leaders.

Either complete the online application below or you may download and print our paper application. Printed applications can be mailed to or dropped off at:

ATTN: Granite Leaders
NH Coalition to End Homelessness
122 Market Street
Manchester, NH 03101

Please complete all fields as instructed.

2017 Granite Leaders Application

Any fields marked with an asterisk (*) must be filled out before submitting. If you have any questions, please contact us at [email protected] or at 603-641-9441 ext. 201.

* Please enter your name.

First

Last

Please enter your email address (if applicable).

Please enter your mailing address (if applicable).

Street Address

Address Line 2

City

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State

ZIP Code

Please enter your phone number or a number we can reach you at.

What is the best time to contact you at? Morning Afternoon Evening

If you do not have a phone number, are you able to come to our Manchester office for a brief orientation meeting?

Yes

No

* Are you currently homeless?

Yes

No

If you answered "No" above, have you been homeless in the past?

Yes

No

* Are you currently or have you previously been involved in any community organization that serves the homeless or other low income populations?

Yes

No

If you answered "Yes" above, please indicate what organization or organizations you have been involved with. Otherwise, skip below.

* Why are you interested in becoming a part of Granite Leaders?

* Do you have a reliable form of transportation?

Yes

No

If you answered "No" above, do you have access to public transportation?

Yes

No

If you answered "Yes" above, would you be able to access the public transportation to travel to Concord and/or Manchester at least once per month for 6 months if you were reimbursed?

Yes

No

Do you have any comments you would like to add?

* Please click the box below - this helps prevent spam.

Applications are due by October 26, 2017. If you have any questions regarding the application, please contact us at 603-641-9441 ext. 201 or at [email protected].

2017 Granite Leaders Application

Any fields marked with an asterisk (*) must be filled out before submitting. If you have any questions, please contact us at [email protected] or at 603-641-9441 ext. 201.

* Please enter your name.

First

Last

Please enter your email address (if applicable).

Please enter your mailing address (if applicable).

Street Address

Address Line 2

City

Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State

ZIP Code

Please enter your phone number or a number we can reach you at.

What is the best time to contact you at? Morning Afternoon Evening

If you do not have a phone number, are you able to come to our Manchester office for a brief orientation meeting?

Yes

No

* Are you currently homeless?

Yes

No

If you answered "No" above, have you been homeless in the past?

Yes

No

* Are you currently or have you previously been involved in any community organization that serves the homeless or other low income populations?

Yes

No

If you answered "Yes" above, please indicate what organization or organizations you have been involved with. Otherwise, skip below.

* Why are you interested in becoming a part of Granite Leaders?

* Do you have a reliable form of transportation?

Yes

No

If you answered "No" above, do you have access to public transportation?

Yes

No

If you answered "Yes" above, would you be able to access the public transportation to travel to Concord and/or Manchester at least once per month for 6 months if you were reimbursed?

Yes

No

Do you have any comments you would like to add?

* Please click the box below - this helps prevent spam.