VetResources Community Network (VRCN) Community of Practice Registration

Coalitions, Collaboratives, Community Boards, Partner Organizations

Intake Registration

Question Title

* 1. Name of community coalition, collaborative effort, or organization

Question Title

* 2. Today's date

Date / Time

Date

Question Title

* 3. Type of Organization

501c3

Volunteer group

501c4

501c19

For profit

Federal agency

State agency

County agency

VA employee

CVEB

Other

Other (please specify)

Question Title

* 4. Are you connected to one of these functioning coalitions or collaboratives already?

CVEB (Community Veterans Engagement Board)

Veteran Community Partnerships (VCP)

DOD Building Healthy Military Communities (BHMC) Pilot

Governors/Mayors Challenge

Other Coalition or Collaborative

Other (please specify)

Question Title

* 5. Type of Program

National

Regional

State-wide

Local

Question Title

* 6. City (ies) or Counties Covered

Question Title

* 7. State(s)

Question Title

* 8. How many Veterans, families, caregivers, and/or survivors can you reach or are currently serving

Question Title

* 9. Do you have an online presence

Yes

List website

Question Title

* 10. Top focus areas (pick more than one)

homelessness and housing

food security

mental health and suicide prevention

transportation

education

employment

financial readiness

family care

caregiver support

survivor assistance

memorial affairs

benefits

health care

access and navigation of VA services and benefits

social and community networking

underserved communities

peer support

community care

other

Other (please specify)

Question Title

* 11. Major goals or outcomes achieved related to Veterans, families, caregivers, and survivors

Question Title

* 12. How many referrals to VA for services?

Question Title

* 13. How many referrals made for peer support services to Veterans and/or caregivers/survivors?

Question Title

* 14. Would you like collaboration from these offices?

Veterans Benefits Administration (VBA) - Benefits, Education, Employment, Housing services, Survivors Assistance

Veterans Health Administration (VHA) - Health care, Community care, Caregiver Support, Mental Health, Suicide Prevention, Peer Support, Volunteerism, Telehealth, Innovation Ecosystem

National Cemetery Administration (NCA) - memorial affairs

Vet Center (readjustment counseling services)

State Department of Veterans Affairs

VA Veterans Experience Office (partnerships, communication, events, outreach, community engagement)

List out VA offices you are currently engaged with

Question Title

* 15. Your email address

Question Title

* 16. Your first and last name

Question Title

* 17. Are you currently listed as an organization on the National Resource Directory?

Question Title

* 18. If you want to request a free consult with the VA's VRCN Team, email VAVEOCommunications@va.gov. Consultative Services include Outreach, Community Engagement, Playbooks, Promising Practices, Tools, Events, Advice, Comms, and Connections to VA and community partners/mentors