employed or Attending School Attending School Attending School Attending School Attending School ⃝ ⃝ ⃝ ⃝ ⃝ attending school? Both Both Both Both Both ⃝ ⃝ ⃝ ⃝ ⃝ Neither Neither Neither Neither Neither ⃝ ⃝ ⃝ ⃝ ⃝ Doesn’t Know Doesn’t Know Doesn’t Know Know Know ⃝ ⃝ ⃝ ⃝ ⃝ Refused Refused Refused Refused Refused ⃝ ⃝ ⃝ ⃝ ⃝ Person 2 Person 3 Person 4 Person 5 Head of Household How long ago Currently Employed/ Currently Employed/ Currently Employed/ Currently Employed/ Currently Employed/ ⃝ ⃝ ⃝ ⃝ ⃝ were you last in school in school in school in school in school employed or in Less than 1 Month Less than 1 Month Less than 1 Month Less than 1 Month Less than 1 Month ⃝ ⃝ ⃝ ⃝ ⃝ school? 1-6 Months 1-6 Months 1-6 Months 1-6 Months 1-6 Months ⃝ ⃝ ⃝ ⃝ ⃝ 6-12 Months 6-12 Months 6-12 Months 6-12 Months 6-12 Months ⃝ ⃝ ⃝ ⃝ ⃝ 1-2 Years 1-2 Years 1-2 Years 1-2 Years 1-2 ⃝ ⃝ ⃝ ⃝ ⃝ 2-5 Years 2-5 2-5 Years 2-5 Years 2-5 Years ⃝ ⃝ ⃝ ⃝ ⃝ 5+ Years 5+ Years 5+ Years 5+ 5+ ⃝ ⃝ ⃝ ⃝ ⃝ Never Employed Employed Employed Never Employed Employed ⃝ ⃝ ⃝ ⃝ ⃝ Doesn’t Know Doesn’t Know Doesn’t Know Doesn’t Know Doesn’t Know ⃝ ⃝ ⃝ ⃝ ⃝ Refused Refused Refused Refused Refused ⃝ ⃝ ⃝ ⃝ ⃝ going to ask you some specific questions about your housing history. Please try to give me your best estimates.” “I’m Head of Household Person 2 Person 3 Person 4 Person 5 When did you become homeless this time? [Ask for a specific date know know know Doesn’t know Doesn’t know ⃝ ⃝ ⃝ ⃝ ⃝ or round to nearest Refused Refused Refused month] Refused Refused ⃝ ⃝ ⃝ ⃝ ⃝ Head of Household Person 2 Person 3 Person 4 Person 5
employed or attending school? ⃝ Attending School ⃝ Both ⃝ Neither ⃝ Doesn’t Know ⃝ Refused ⃝ Attending School ⃝ Both ⃝ Neither ⃝ Doesn’t Know ⃝ Refused ⃝ Attending School ⃝ Both ⃝ Neither ⃝ Doesn’t Know ⃝ Refused ⃝ Attending School ⃝ Both ⃝ Neither ⃝ Know ⃝ Refused ⃝ Attending School ⃝ Both ⃝ Neither ⃝ Know ⃝ Refused Head of Household Person 2 Person 3 Person 4 Person 5 How long ago were you last employed or in school? ⃝ Currently Employed/ in school ⃝ Less than 1 Month ⃝ 1-6 Months ⃝ 6-12 Months ⃝ 1-2 Years ⃝ 2-5 Years ⃝ 5+ Years ⃝ Never Employed ⃝ Doesn’t Know ⃝ Refused ⃝ Currently Employed/ in school ⃝ Less than 1 Month ⃝ 1-6 Months ⃝ 6-12 Months ⃝ 1-2 Years ⃝ 2-5 ⃝ 5+ Years ⃝ Employed ⃝ Doesn’t Know ⃝ Refused ⃝ Currently Employed/ in school ⃝ Less than 1 Month ⃝ 1-6 Months ⃝ 6-12 Months ⃝ 1-2 Years ⃝ 2-5 Years ⃝ 5+ Years ⃝ Employed ⃝ Doesn’t Know ⃝ Refused ⃝ Currently Employed/ in school ⃝ Less than 1 Month ⃝ 1-6 Months ⃝ 6-12 Months ⃝ 1-2 Years ⃝ 2-5 Years ⃝ 5+ ⃝ Never Employed ⃝ Doesn’t Know ⃝ Refused ⃝ Currently Employed/ in school ⃝ Less than 1 Month ⃝ 1-6 Months ⃝ 6-12 Months ⃝ 1-2 ⃝ 2-5 Years ⃝ 5+ ⃝ Employed ⃝ Doesn’t Know ⃝ Refused “I’m going to ask you some specific questions about your housing history. Please try to give me your best estimates.” Head of Household Person 2 Person 3 Person 4 Person 5 When did you become homeless this time? [Ask for a specific date or round to nearest month] ⃝ know ⃝ Refused ⃝ know ⃝ Refused ⃝ know ⃝ Refused ⃝ Doesn’t know ⃝ Refused ⃝ Doesn’t know ⃝ Refused Head of Household Person 2 Person 3 Person 4 Person 5