Lion House Housing Application
This application is for transitional and rapid rehousing. This is not for emergency utility and rent assistance. Case Managers will reach out to you once application has been submitted to do an intake assessment. (Some Emergency Housing is available for those ages 18-24)
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Email *
Name (First, Last) *
Please describe your race:

 *
Date of Birth *
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Age *
Gender *
Pronoun(s) *
Do you identify as LGBTQ+? *
Do you currently have children in your custody? *
Are you a Wyandotte County resident? *
Where are you living right now (house/apt, friends, relatives, shelter, hotel, street, car, other)? *
Phone Number *
Email *
Alternative means of contact (Facebook, Instagram, etc.) *
Preferred method of contact? *
Have you ever applied to this program? *
How did you hear about Lion House? *
Do you know anyone who is or has been in the Lion House program? *
What are your reasons for applying to the Lion House program? *
Have you ever been in any other independent living program? (Examples include Hillcrest, ReStart, Synergy) *
Are you currently working with a case manager? (If yes, please list name and contact number) *
What form of transportation do you use? *
Are you currently enrolled in school? (If yes, please list school name) *
Are you currently fully vaccinated against COVID-19? *
Let us know if you have any questions about the Program, or further comments on any sections of the applications.
A copy of your responses will be emailed to the address you provided.
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