VetResources Community Network (VRCN) Community of Practice Registration

Coalitions, Collaboratives, Community Boards, Partner Organizations

Intake Registration

Request a consult with VEO for community engagement, outreach, event, and comms support by emailing VAVEOCOMMUNICATIONS@VA.GOV

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

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* 2. Today's date

Date / Time

Date

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* 3. Type of Organization

501c3

Volunteer group

For profit/Private

Federal agency

State agency

County agency

VA employee

CVEB

VSO

Other (please specify)

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

CVEB (Community Veterans Engagement Board)

Veteran Community Partnerships (VCP)

Governors/Mayors Challenge

Other Coalition or Collaborative

Other (please specify)

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* 5. Type of Program

National

Regional

State-wide

Local

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* 6. City (ies) - where organization resides

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* 7. State - where organization resides

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* 8. Zip codes for the areas you serve (list)

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* 9. Counties (areas you serve)

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

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* 11. Do you have an online presence

Yes

List website

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* 12. 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

transition

fitness and sports

gaming

rural engagement

Other (please specify)

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

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* 14. How many referrals to VA for services?

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

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* 16. 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

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* 17. Your email address

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* 18. Your first and last name

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

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* 20. 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

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* 21. Are you currently engaged with VA

Yes

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* 22. Do you trust VA to provide care and benefits to our nations Veterans?

Yes

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* 23. Would you like a consult with VEO for community engagement, outreach, event, and comms support? If yes, email us at VAVEOCOMMUNICATIONS@VA.GOV

Yes