Resources & Resiliency Digital Education Program Registration Form
Date of Birth
Residence (you must be a resident of a shelter or transitional housing program to register)
Best phone number to reach you
Can you receive texts at this number?
How would you rate your computer skills on a scale from 1 to 5 where 1 is "No skills at all" and 5 is "Very highly skilled?
No skills at all
Very highly skilled
Which session are you registering for?
Housing Module | Monday/Wednesday/Friday | September 10, 12 &14 - 10:00 am – 1:00 pm
Parenting & Education Module | Monday/Wednesday/Friday | September 24, 26 &28 - 10:00 am – 1:00 pm
Job Search Module | Monday/Wednesday/Friday | October 1, 3 & 5 - 10:00 am – 1:00 pm
Housing Module | Monday/Wednesday/Friday | October 15, 17 & 19 - 10:00 am – 1:00 pm
Please note that completing this form does not guarantee you a place in the program. Someone from LSH will contact you to confirm your eligibility and set up a time for you to come to orientation.
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This form was created inside of Lutheran settlement house.
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