Referral to Community Action Board (CAB) for Voice Mail Service
Santa Cruz Address: 501 Soquel Ave, Suite E. Santa Cruz, Ca 95062
Phone: 831/457-1741 - Fax:831/457-0617

Watsonville Address: 406 Main Street, Suite 220, Watsonville, CA 95076
Phone: 831/728-4634 - Fax:831/728-5641

Date:__________________ New Referral____ Extension___

Name of Client:_____________________ Voice Mail Box #_______

Number of People in Family:_____ Referring Agency: ____________Phone #:___________

Agency Representative: __________________Title:_________________

Signature of Agency Representative:_____________________________

Description of Need: (example: Work, housing, contact with medical workers) _______________________________________________________________________________.

Documentation of Eligibility: (Please Attach copy to Referral Form)

( ) Photo Id ( ) SSI Card ( ) Proof of Income __________________________________________________________

The Shelter Project Message Center provides a voicemail for homeless people in emergency and transitional shelter facilities or on the street, or people who are at risk of homelessness.  Clients have use of a voicemail box for 16 months. Extensions are approved at 8 months upon updated referrals from local providers of services to people living in or near poverty.  If a client does not use their voicemail box for three months it is subject to being closed.  Clients must meet Shelter Project Income guidelines.

Client Sign Here: __________________________________________________________

I have read and understand the contents of this form: 

NOTE: The Message Center of The Shelter Project operates by "drop in" on Wednesday afternoon from 1 PM to 4:30 PM in Santa Cruz and Watsonville (see address above for location).

message center referral - 9/2005