TESTER TRAINING

JUNE 14, 2024 - 10:00AM TO 12:30PM

You must complete the following Tester Application form, and submit the required, signed and dated Confidentiality Agreement below no later than 12:00 PM, June 13, 2024. You must answer the questions marked with red asterisks (*) or the form will be deemed incomplete.

Once you have completed the Tester Application form and submitted the necessary, signed and dated Confidentiality Agreement, you will be provided with the Zoom link after the June 13 deadline. If you have any questions, please contact Angie@echofairhousing.org.

Attendees are required to have their cameras ON during the training. Attendees will not be able to participate without being visible.

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TESTER APPLICATION

CONTACT INFORMATION

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

How do you prefer to be contacted? *

Home/Cell Phone

Text

Email

Work Phone

EMPLOYMENT INFORMATION

Occupation *

Employer *

Street Address *

Address Line 2

City *

State *

Zip Code *

Work Phone Number *

Email Address

PERSONAL INFORMATION

Have you ever been convicted of a felony? *

Yes

No

Date of Birth: * +

Sex/Gender: *

Female

Male

Non-binary

Ethnicity *

Race *

Complexion? *

Hair Color? *

Do you look older than your age? *

Do you look younger than your age? *

Other distinguishing characteristics?

What languages do you speak? *

TESTING INFORMATION

Do you have experience with discrimination testing? *

Yes

No

When and where did you receive training? *

Do you have a Drivers' License? *

Yes

No

Do you have reliable transportation? *

Yes

No

Are you available on short notice? *

Yes

No

Which days/times are you available for testing?

	9am - 12pm	12pm - 3pm	3pm - 6pm
Monday	9am - 12pm	12pm - 3pm	3pm - 6pm
Tuesday	9am - 12pm	12pm - 3pm	3pm - 6pm
Wednesday	9am - 12pm	12pm - 3pm	3pm - 6pm
Thursday	9am - 12pm	12pm - 3pm	3pm - 6pm
Friday	9am - 12pm	12pm - 3pm	3pm - 6pm
Saturday	9am - 12pm	12pm - 3pm	3pm - 6pm

Testing availability for Alameda County: *

North County

South County

Tri-Valley

None

Testing availability for Contra Costa County: *

Central County

East County

West County

None

Testing availability for Monterey County: *

Monterey Peninsula

North Salinas Valley

South Salinas Valley

None

Have you ever encountered housing discrimination? If so, please describe your experience below.

Please explain why you are interested in being a fair housing tester. *

Who should be contacted in the event of an emergency?

First & Last Name *

Phone Number *

Email Address *

Relationship *

CONFIDENTIALITY AGREEMENT

Please download the Confidentiality Agreement document, sign and date it, and upload using the Confidentiality Areement uploader below.*

Confidentiality Agreement

Confidentiality Agreement Uploader *

DATE & SIGNATURE

Date * +

The information I have provided on this application is true and correct. As an investigator for Eden Council for Hope and Opportunity (ECHO), I promise to report objectively the facts of each investigation and to keep confidential any information obtained in the course of my role as an investigator. *

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