Homelessness Housing Services

Homelessness Housing Services

Completing this form does not guarantee services. Please allow 72 business hours to process. Requests to expedite or bypass established procedures cannot be accommodated, as doing so may compromise compliance and fairness. Any information provided below are confidential and will not be shared with any other party.
Personal Information
Are you currently homeless?*
Name*

First NameLast Name
Phone*

Area CodePhone Number
Birth Date*

MonthDayYear
Email*
example@example.com
Race*
Ethnicity*
Gender*
Marital Status*
Are you a veteran?*
Do you have an identification card?*
If so, for what state?*
Identification Number*
What county are you in?*

DallasEllisCollinTarrantOther
Do you have children with you under the age of 18?*
Basic Information

Eligibility for this program requires that the client is homeless AND has an income, as the client will have to self qualify for housing. Completing this form does not guarantee services.
What is your current housing status?*
Are you currently residing with or trying to leave an intimate partner who has made you fearful or has threatened you?*
Are you currently working or receiving any forms of income?*
Proof of income (check stubs, award letters, etc) for 2 months.*

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Can we make referrals on your behalf to other agencies that may offer services that we are unable to accommodate?*
Is there any other information that you would like to share based on your situation that may be important for us to be aware of?*
How did you hear about Faith Formula Human Services?*
Should be Empty:

Homelessness Housing Services

Personal Information

Basic Information