UNITY Warehouse Requisition Form
For UNITY and our partner organizations to request household goods and furniture for recently-housed, formerly homeless folks.
506 N. St. Patrick St.
New Orleans, LA 70119
(between Bienville St. and Orleans Ave., near City Park Ave.)
Our hours are:
Monday--Thursday 9AM - 1PM.
Program staff should request available items through this form.
Recently housed clients may make accompanied visits to the warehouse to select and pick-up available items.
Furniture and household goods are provided on an as available basis.
Client and Requisitioner Information
1) Client Name
Please enter the first and last name of the head of household.
Client's Street Address, Unit #, City, and ZIP Code.
3) Client's Phone Number(s)
Primary & alternate numbers whenever delivery is requested, note when number belongs to an associate.
4) Case Worker / Housing Specialist
Name of person submitting the requisition form and, when pertinent, a UNITY affiliated worker.
5) Agency and Program Name
Name of Agency and Program for which Requisitioner works and/or which supports client.
6) Caseworker / Housing Specialist Office Phone Number
7) Caseworker / Housing Specialist Cell Phone Number
8) Caseworker / Housing Specialist E-mail Address
Client Data and Eligibility
9) Program List
Please indicate what program is PAYING for clients' housing and/or case management services
CCANO - Bridges to Self-Sufficiency
CCANO - Transformation
CCANO - Voyage House
Covenant House - Permanent Housing for Youth
Covenant House - Rapid Rehousing for Survivors
Covenant House - Rapid Rehousing for Youth
Covenant House - (S+C)
Crescent Care - NOATF Permanent Housing
Crescent Care - Partners in Health and Housing
Crescent Care - PSH (STATE S+C)
Crescent Care - TBRA
DePaul USA / HTC - Coming Home PSH
DePaul USA / HTC - Rapid Rehousing
DePaul USA - Safe at Home
Goodwill Industries - Home at Last Esplanade
Goodwill Industries- PSH
Goodwill Industries - Safe at Home
Hope Center - (SSVF)
JPHSA - Supportive Housing for Persons with Disabilities - Consolidated
MHSD - S+C (Cov. House, OHL, McCaleb, Magnolia Villa, OHL, RHD - JP ACT, RHD - Metropolitan ACT, START, or UNITY)
NAMI - Finally Home
NAMI - Womanspace
NOEII - CABHI (Crescent Care, NAMI, VOA)
NOFJC - Rapid Rehousing for Survivors
NOFJC - Turning Point Project
NOWCS - RRF
OHL - Samaritan
OHL - Shelter Plus Care (S+C)
Ozanam Inn - Home for Good
Ozanam Inn - RRH to Reduce Homelessness
Ozanam Inn - Safe at Home
Priority Healthcare - Safe at Home
Responsibility House - JP Street Outreach
Responsibility House - New Keys Expansion Program
Responsibility House - Pathways PSH
Salvation Army - RRF
START - New Start Housing
START Corp. - Partners in Health and Housing
START Corp. - PSH (STATE S+C)
START Corp. - Rapid Rehousing for Families
START Corp. - Rapid Rehousing to Reduce Unsheltered Homelessness
START Corp. - SSVF
Traveler's Aid Society - ESG Rapid Rehousing
Travelers Aid Society - Journey Home
Tulane Drop-In Center - Project Home
UNITY Rebuilding Communities (STATE S+C)
UNITY - Safe at Home
UNITY Welcome Home - Rapid Rehousing
VA - HUD VASH
VOA - PSH (STATE S+C)
VOA - SSVF
10) Household Furnishings
Is the client's apartment already furnished?
I don't know
Does client have any income?
Yes, work (FT, PT, or temporary)
Yes, child support
Yes, disability support (i.e. SSI)
12) Veteran Status
Has the client (or any member of their household) ever been a member of any branch of the Armed Forces?
Client prefers not to indicate
13) Number in Household
How many people are currently inhabiting this home?
9 or more
14) Recent, Literal Homeless
Has the client experienced recent, literal homelessness (slept primarily on the street, in a shelter, in a vehicle, or in an abandoned building)?
I don't know
Emergency Shelter in Hotel
Starter Kit / Household Supplies / Furniture Request
PLEASE MARK OR LIST ALL REQUESTED ITEMS
15) Starter Kit (Kitchen Supplies, Bed & Bath Linens, Toiletry & Cleaning Supplies) [one per household member]
Contents include tableware, cooking utensils and dishes; sheets, pillows and towels; toiletries and 1 or 2 house cleaning items. Kits must be picked up Monday - Thursday 9AM to 1PM.
16) Household Supplies
Please be specific. Requested Household Supplies not included in Starter Kit (will be provided as available at the time of request).
17) Requested Furniture Items
Please be specific. Items will be provided as available at the time of request. No waiting lists for items are kept.
18) Starter Kit / Household Supplies / Furniture Pick Up Date
Starter Kits must be picked up by program staff. Please select the date (M-Th) you plan to come.
19) Planned Client Visit Date
Program staff is encouraged to bring clients to select items during regular warehouse hours. If you plan to bring a client, please select the date (M-Th) you plan to bring your client.
20) Preferred Furniture Delivery Date
Deliveries are available for selected large furniture items on an "as available" basis. Deliveries take place Mon-Thu afternoon and throughout the day on Friday.
When completed, please print this page for your records before selecting "Submit."
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