2012 Point-in-Time Count Forms

 The 2012 Point-in-Time Count will be held the night of Wednesday, January 25.
 
The forms below should be used to report data for the count.  Please see the instructions for how to use each form.
 

Sheltered Count Forms 

Each emergency shelter, transitional housing program, and permanent supportive housing program in the state must fill out one of these forms.
  • Programs in the Balance of State CoC should turn the forms in to NCCEH.
  • Programs in all other CoCs should turn the forms in to their local PIT coordinator.
Sheltered Count Form
 


Unsheltered (Street) Count Forms

Communities conducting street counts or services-based counts of unsheltered homeless persons should use this form to report their data.
  • Programs in the Balance of State CoC should turn the forms in to NCCEH.
  • Programs in all other CoCs should turn the forms in to their local PIT coordinator.
Unsheltered Count Form
 
 

NC Homeless Demographic and Needs Survey

This is an optional survey that can be used while interviewing homeless persons during the count to collect information that must be included on the Sheltered Count and Unsheltered Count forms.
  • These forms do not need to be turned in to NCCEH.  Check with your local PIT coordinator to see if forms are being collected locally.
  • This form was created with assistance from HUD TA providers. You may edit this form according to your community's needs. If you'd like an editable version of this form, please contact NCCEH at data@ncceh.org.
NC Homeless Demographic and Needs Survey
 
 

Continnum of Care Reporting Form

This form is for CoC leadership to report the CoC's total count to the State of North Carolina. 
  • Communities in the Balance of State CoC do not need to fill out this form.
  • All other CoCs in North Carolina must submit one of these forms to NCCEH.
CoC Reporting Form
 
 

Imminently Literally Homeless and At-Risk of Homelessness Form

This form is for communities to count numbers of people who are imminently literally homeless and at-risk of homelessness.
  • This form is optional.  Check with your local PIT coordinator to see if forms are being collected locally.
Imminently Literally Homeless and At-Risk Form
 
 

2012 Point in Time Count Training

NCCEH held a PIT Count training on January 6, 2012.  view PowerPoint presentation