Shadow Count 2023 Decoy Registration

Shadow Count Program at Silberman SSWShadow Count 2023 Decoy Registration

Shadow Count 2023 will take place on the night of Tuesday, January 24th into Wednesday, January 25th 2023.

• Decoys are required to check in at their pre-assigned borough locations at 10:00 p.m. on Tuesday, January 24th -- two hours prior to the Count's official start at midnight. You will get this assignment at the training session you attend.

• The Shadow Count will officially end at 4:00 a.m. (Wednesday, January 25th).

• As a decoy you will be compensated $90.

• You must be at least 18 years of age or older to participate.

• Please complete the following application if you are interested in being a Shadow Count decoy. It is very important that we receive accurate information. Please make sure that you have filled out the following form completely before submitting.

I hereby certify that I am 18 years of age or older. (If you are not, you are not eligible to be a captain.) *

I hereby certify that I am 18 years of age or older. (If you are not, you are not eligible to be a captain.) Yes, I am 18 years or older.
I have been vaccinated against Covid-19 and have proof of my vaccination. *

I have been vaccinated against Covid-19 and have proof of my vaccination. Yes, I am vaccinated and have proof.
Name Name * First Last
Address (please include apt# if applicable) Address (please include apt# if applicable) *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Primary phone # please include area code: Primary phone # please include area code: * - ### - ### ####
Alternate phone # please include area code: Alternate phone # please include area code: - ### - ### ####
Email *
• How did you hear about Shadow Count?
* All decoys are required to attend a training session in order to be able to participate in the Shadow Count.

Be sure to write your choice down.

*** In-person training will be held at the
Silberman School of Social Work
2180 Third Avenue at E. 119th Street, New York, NY 10035
Room 115

[PLEASE NOTE: YOU CANNOT GET INTO SILBERMAN SSW WITHOUT A PHOTO ID AND PROOF OF COVID 19 VACCINATION.]

*** Virtual trainings will be held on Zoom. If you choose the virtual training a link will be sent to the email you provided on this form closer to the date of your training. Please be sure to regularly check and read any emails you receive regarding Shadow Count between registering and the date of Shadow Count.

PLEASE, be sure to make a note for yourself about the training you are registering to attend.

• Choose one: *

* All decoys are required to attend a training session in order to be able to participate in the Shadow Count.

Be sure to write your choice down.

*** In-person training will be held at the
Silberman School of Social Work
2180 Third Avenue at E. 119th Street, New York, NY 10035
Room 115

[PLEASE NOTE: YOU CANNOT GET INTO SILBERMAN SSW WITHOUT A PHOTO ID AND PROOF OF COVID 19 VACCINATION.]

*** Virtual trainings will be held on Zoom. If you choose the virtual training a link will be sent to the email you provided on this form closer to the date of your training. Please be sure to regularly check and read any emails you receive regarding Shadow Count between registering and the date of Shadow Count.

PLEASE, be sure to make a note for yourself about the training you are registering to attend.

• Choose one: In-person training at Silberman School of Social Work: Tues. Jan 17th, 7pm - 9pm Virtual training via Zoom: Wed. Jan 18th, 11am - 1pm In-person training at Silberman School of Social Work: Thurs. Jan 19th, 3pm - 5pm
• Have you volunteered for previous Shadow Counts?

• Have you volunteered for previous Shadow Counts? 2016 or earlier 2017 2018 2019 2020
• If you previously volunteered, did you serve as a decoy (Shadow Count) or as a counter/enumerator (Hope Count)?

• If you previously volunteered, did you serve as a decoy (Shadow Count) or as a counter/enumerator (Hope Count)? Decoy Counter/Enumerator Both
• Are you a student? (optional)

• Are you a student? (optional) Yes No
• Have you ever experienced homelessness?

• Have you ever experienced homelessness? Yes No Prefer not to answer
• Are you currently experiencing homelessness?

• Are you currently experiencing homelessness? Yes No Prefer not to answer
Add details about your housing situation if desired.
Maximum of 40 words allowed. Currently Entered: 0 words.
You must bring the following original or photocopied documents with you on the day of your in-person training. Original documents are preferred whenever possible:

• A valid photo I.D. that shows your date of birth. (Examples: driver's license, passport, benefit card.)

• Your Social Security card

• Proof of your Covid-19 Vaccination

IF YOU ARE DOING A VIRTUAL TRAINING, YOU WILL BE REQUIRED TO BRING THESE DOCUMENTS TO YOUR PLACEMENT ON JANUARY 24th!
WAIT!

• Make sure you have fully completed this form!
- Include a contact number and/or E-mail address.
- Choose a training date.
- Don't forget to write down the training date you will be attending for your own records.

• Click the submit button to complete this application.

If you have any questions, please contact us by email or phone.

Shadow Count Email: shadowcount@hunter.cuny.edu

Shadow Count Hotline (Please leave a message and it will be returned ASAP): 212-396-7766

Thank you for your support and participation. We look forward to seeing you at the decoy training!

Comments:
We thank you for your support and involvement in this valuable initiative!
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Shadow Count 2023 Decoy Registration

Shadow Count Program at Silberman SSWShadow Count 2023 Decoy Registration

We thank you for your support and involvement in this valuable initiative!