Rapid Re-Housing Application
COTS Rapid Re-Housing program assists families and individuals in becoming stably housed and self-sufficient through short-term financial assistance and supportive services.

In order to meet the basic eligibility criteria, you must be:
- Homeless at the time of application
- Resident(s) of Sonoma County

Name (First and Last) *
Your answer
Email *
Your answer
Phone Number *
Your answer
Alternate Phone Number
Your answer
Where are you/your household currently staying? *
Are you currently living in Sonoma County? *
Date of Birth *
MM
/
DD
/
YYYY
Have you ever served in the United States Military? *
Number of people in your household (including yourself) *
List the names and dates of birth for all additional household members.
Your answer
We are collecting information about how people experiencing homelessness have been affected by the Sonoma County fires in October 2017. How were you / your household affected? (Check all that apply.)
What city did you stay in last night?
Enter the address of your last permanent housing location before your current episode of homelessness.
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
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