Building Our Own Systems: Emergency Housing for LGBTQ+ Youth 18-24 in Louisiana
LGBTQ+ youth in Louisiana (and across the country) are significantly more likely than their cisgender and straight peers to experience homelessness. Many have been rejected by their families of origin due to their sexual orientation and/or gender identity. Transgender youth and black LGBTQ+ youth experience homelessness at the highest rates within the community. Louisiana's social services landscape is limited in its capacity to provide services to people experiencing homelessness, especially LGBTQ+ people who may fear facing violence or discrimination at emergency shelters. This form is to collect information from individuals and families who are willing to provide a safe place for LGBTQ+ youth to stay on a short-term, intermediate-term, or long-term basis.
Email address *
About You + Your Household
What is your full name? *
Your answer
What are the first names, ages, and relationships to you of any other members of your household?
Format: First Name - Age - Relationship to You
Your answer
What is your street address? *
Your answer
What city do you live in? *
Your answer
What is your zip code? *
Your answer
What is your phone number? *
Your answer
Do you have any pets? *
Required
Do you have access to reliable transportation? *
What kind of space can you provide to an LGBTQ+ young person? *
What is your gender identity? *
What is your sexual orientation? *
What is your age? *
Can you provide us with the names, contact information, and a brief description of your relationship (friend, family member, faith leader, colleague, etc.) for 3 people who could serve as references? *
While we are specifically collecting information in order to make connections to adults who can serve as a resource for LGBTQ+ youth ages 18 and older, we recognize that there is still the risk of harm when providing referrals to young people who are experiencing homelessness. We take the safety of LGBTQ+ youth extremely seriously.
Your answer
About Your Commitment
Are you able to provide: *
Please check all which apply.
Required
Do you have sufficient financial resources to meet the above commitment(s)? *
Are your household's financial resources sufficient to be able to meet the basic needs of a young person for the length of your commitment, including food, clothing, toiletries, transportation, prescription medications, etc.
Are you able to accommodate a young person with any of these physical disabilities: blindness, deafness, or limited mobility? *
A young person with a disability impacting their mobility might not be able to navigate steps. Think about whether your available space is on the ground floor of your house or an apartment building, whether your house has exterior steps, whether your transportation can accommodate a wheelchair, etc.
Your answer
Is there any other information you would like to share about your household or your capacity to provide housing to an LGBTQ+ young person in Louisiana?
Your answer
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