My Forever Home - Admissions Application

Thank you for your interest in My Forever Home.  The focus of My Forever Home is to create a community of individuals with special abilities within a community in an upcoming development in Smithfield, NC. Slated to complete the first phase of construction in June 2026, it will consist of 10 two-bedroom detached homes within a larger 300-home community.

This form is the first step in our formal application process for those interested in moving into the My Forever Home community – this form does not place someone on a waitlist for housing.  Our application process follows a three-tiered plan:

  • Tier 1 – We gather information about the potential future resident, his or her contact information, where he or she resides, his or her diagnosis and other basic information. Someone from My Forever Home Admission Team will be in contact within 2-4 weeks after submitting your survey form.
  • Tier 2 – The Admission Team will contact you to discuss your situation, the potential resident and current needs. After this discussion, if it is agreed that the potential resident is a good fit for the community, then he or she will be invited to join the current residents during one of their monthly outings. The current residents meet monthly for a weekend activity or for dinner. It is important that potential residents interact with the current residents to confirm suitability. If all are in agreement, the potential resident would move to the next phase of meeting individually with the current residents to ensure compatibility.
  • Tier 3 – Once the potential resident is confirmed for suitability among the current residents, he or she will be added submitted into the Charles Lee Admissions process. The future resident will continue to receive updates on his or her wait-list status and notices of all social activities planned in the community.
Please note: All responses are confidential and will not be shared outside of My Forever Home without your permission.  Completing this application DOES NOT guarantee or secure a residence.  Completing this form DOES NOT place someone on a waitlist for housing. Additional information will be provided upon your submission.

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Email *

What is the name of the person completing this form?

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The person completing this survey is (select all that apply):

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Required

What is the prospective resident's full name?

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What is his or her current full address (Street, City, State, Zip)?

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What is his or her date of birth? (You must be 18+ to live in a My Forever Home Property)

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What is his or her email address?

What is his or her phone number?

What county does the prospective resident live in?

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Does the prospective resident have an intellectual developmental disability? (Some examples are Autism Spectrum Disorder, Down syndrome, Fragile X syndrome)

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If so, please specify the diagnosis.
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How does the prospective resident communicate (select all that apply)?

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Does the prospective resident have a legal guardian?

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Does the prospective resident currently have the NC Innovations Waiver?
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If you answered yes to the question above, please indicate below which type of services are currently being used.
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Required
What type of financial support does the prospective resident currently receive?
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Required
How did you hear about us? *
Who is the prospective resident's current service provider?
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What is the current living status of the prospective resident?

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Please indicate what other types of living environments the prospective resident has experienced.

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Does the prospective resident currently have a pet or an emotional support animal or therapy dog?
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Is there any other information you wish to provide at this time (NA if none)?

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Do you have any initial questions that you would like the Admissions Team to address (NA if none)? *
Who should the My Forever Home Team contact about your interest? *
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