For agencies, case managers, workforce / VA partners, and community organizations
How your submission is handled. This form is sent over an encrypted (HTTPS) connection to PLRK’s designated business email and stored in the website’s protected administrative area, which only authorized PLRK administrators can open. If you provide an email address you will receive an automatic confirmation copy. Acknowledgment checkboxes are recorded with a date and time stamp as part of your submission; they document your acknowledgment but are not a notarized or certified electronic signature.
Please do not enter Social Security numbers, full bank or card numbers, medical diagnoses, confidential shelter locations, or sensitive safety narratives. If you need to share documents, PLRK will arrange a secure method with you directly.
