Housing Waitlist Form 

The GLO Housing Program is designed to support members of the LGBTQ+ community of color who are experiencing housing instability. This program is available for individuals between the ages of 18 and 34.

If you believe you qualify, please complete this waitlist form. Once submitted, your information will be added to our housing waitlist. We will contact you when funding becomes available to discuss next steps and potential assistance options.

Please note that submitting this form does not guarantee immediate housing placement or financial assistance, but it ensures you will be considered as resources become available.

We appreciate your interest in the GLO Housing Program and your patience as we work to support our community.

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Email *
Name *
Age *
How do you identify? (check all that apply)

 *
Required
Phone *

Are you currently in need of assistance with any of the following?

 *
If you have unpaid rent,  how much do you owe in total?
How much is your monthly rent amount?
If you received a written eviction notice, What date did you received it?
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DD
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What date does the notice say you must vacate the property? 
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/
DD
/
YYYY
Who issued the eviction notice (landlord, property management, court, etc.)? 

If you are seeking assistance for a new place, What unit size is needed? *
Preferred Contact Method *
Required
Question or Concern
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