Shepherds Of Independence - Application for Tenancy
Villa Lucia 1400 Morgan St. NW
Villa Rose 1355 Walker Ave NW
Grand Rapids MI 49504

Phone #: 616-732-6351
Fax #: 616-732-6352

Personal Information
Full Name *
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Contact Phone Number *
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Sex
Current Situation
Current Address/Facility *
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Case Manager
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Case Manager Phone #
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Agency
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Team
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Guardian Name, Address and Phone #
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