Here at Family Promise, the goal is to keep families together. We work solely with families who have children under 18 and are currently working. We provide families with a safe sleeping space within a local congregation from 6 pm to 6 am, we also providing meals, mentoring, and case management. At 6 am families are brought via bus to the day center. The Day Center becomes the address on record. This means children will be bused to schools from here. Parents will go on to work from the Day Center.

Please note our Prevention Program assists families who have children under 18, are working, and owe less than $1500 in back rent. We help families by working with Landlords to keep families stably housed. Our program heavily focuses on case management and distributes approximately $1,000 over the course of three months.

WE DO NOT have rental assistance to help families with first month, last month or security deposits.

If you believe we can assist you please complete this form. Our case manager will reach out to you within 3 business days.

Name

First Name

Last Name

Phone Number

Is your family currently experiencing homelessness and looking for shelter?

For families currently experiencing homelessness.

Yes

Are you interested in the Prevention Program

The Prevention Program is designed for families who are on the verge of experiencing homeless. It is $1,000 over the course of 3 months that goes towards your rent, and includes case management services

Yes

Amount you currently owe on rent

Have you ever experienced domestic abuse, have an active protection order in place, or a Child and youth case?

Name and relation of adults over 18

Date/Time Submitted

Number of Kids under 18

Name of Kids and Date of Birth

Have you ever stayed in a shelter before?

In the last three years how many times have you been homeless?

Where did you stay last night?

Current/Past Living Situation

Current Employment

Employment location/ and hourly income

Please put Adult 1: Adult 2:

Do you recieve child support/Social Security Income/TANF?

Please indicate if you receive it for yourself or for a dependent

How much do you receive in Child Support/SSI/TANF

Please indicate how much you receive per service (If you do not put N/A)

Do you have any mental health diagnoses, or drug and alcohol use issues

If you do please state if you are receiving treatment

Do you have a vehicle?

Referral (how you heard about us)

Additional information

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