I Need Housing
If you are in need of housing and have a child 12-17 you may qualify for housing, please fill out the form below.
If Our House or a Host Home is available we will contact you for a phone interview. We collaborate with other agencies which may lead to other housing opportunities through those agencies. We only house single parent families with one or more teenager. We do not take a waiting list.
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First Name *
Last Name *
Email *
Phone number at which you can be reached *
What county are you in? *
What is your marital status *
What city did you sleep in last night? *
What city is your child's school located in? *
Are you employed? *
If employed what city do you work in?
When you became or will become homeless *
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Letter describing your situation *
Be sure to describe what caused you to become homeless and to include your plans to find permanent housing.
Child's First Name *
Child's Last Name *
Child's Age *
Child's Gender *
Do you have another child?
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Be sure to click [SUBMIT] on the next page so that we get your response.
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