Move Up Voucher Request
ALL REQUESTS RECEIVED BY 11:59:59 ON WEDNESDAY WILL BE REVIEWED FOR ELIGBILITY AND REFERRAL TO A PARTICIPATING HOUSING AUTHORITY BY CLOSE OF BUSINESS ON FRIDAY.  

Please note: Move Up Requests are only accepted from Housing Providers in the River Valleys CoC region on behalf of participants currently in their Rapid Rehousing, Transitional Housing, or Permanent Supportive Housing program.

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Email *
Phone number *
of Provider Staff submitting request
Contact Name *
 of Provider Staff submitting request
Participant Name *
Participant HMIS ID
Required for participants in non-DV programs
Participant Phone
Participant other way(s) to contact
Housing Program Name *
Program name where the Participant is staying or receiving service. (This should be the Program name you provided on your Program Eligibility Form for Coordinated Entry participation.)
Housing Program Type *
of housing where Participant currently lives
Housing Unit Type within Program *
where Participant currently lives
Date Participant Entered the Program *
From HMIS or alternate database record
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