Indy Convergence 2012 Application

Please complete this form and return it along with your resume, work sample and $10 nonrefundable application fee by January 15 to be considered for financial assistance from The Indy Convergence. All other applications are due by February 12. Please email Robert at Robert@indyconvergence.org with application questions.

The Indy Convergence houses its participants in the homes of Indianapolis community members. They are not being paid, and it is one of our highest priorities to make sure that living arrangements are a pleasant experience for both parties. Please understand that while do not anticipate any issues, if a participant loses their housing for any reason, we may not be able to secure new housing. For everyone's sake, please err on the side of telling us more than telling us less.

all applications are confidential
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    Housing Questions

    If you live in Indianapolis, please skip this section and procede to the In Case of Emergency section
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    In Case of Emergency

    Please answer the following questions in the event of your being admitted to a hospital.
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    Emergency Contact

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    all applications are confidential