FPGV Housing Programs Application

Family Promise of Gallatin Valley - Housing Programs Application
Important Note

Families who apply to Family Promise of Gallatin Valley programs MUST have at least one child under the age of 18 years old in their primary custody (50% or more), or be pregnant at the time of application. If you do not meet these requirements, you are not be eligible for FPGV programs and your application will not be processed.
Primary Contact - Full Name*

First and Middle Name(s)Last Name 1, Last Name 2
Date of Birth*

MonthDayYear
Preferred Pronouns*
Most Recent Permanent Address*

Street Address

Street Address Line 2

CityState

Zip Code
Email Address*
Phone Number*
Social Security Number*
If you do not have a social security number, please write "no" in the box.
Relationship to Children*
Examples: mother, father, sibling, grandparent, foster parent, etc.
Race *
Hispanic / Latinx?*

YesNo
How long has your family lived in the state of Montana?*
How long has your family lived in Gallatin County?*
How many children (under the age of 18 years old) do you have in your primary custody (50% or more)? *
Please only select the number of children that are currently in your primary custody (50% or more). If your children are in the custody of the state, please indicate that above.
Thank you for your interest in Family Promise of Gallatin Valley programs. Unfortunately, you are not currently eligible for FPGV's programs. Please reach out to other resources for assistance.

HRDC - 406.587.4486 // Love Inc - 406.587.3008 // Salvation Army - 406.586.5813
How many OTHER adults are in your family (not including yourself)?*
Other Adult in Household (#2)*

First and Middle Name(s)Last Name 1, Last Name 2
Date of Birth*

MonthDayYear
Social Security Number*
If you do not have a social security number, please write "no" in the box.
Relationship to Primary Contact*
Examples: husband, wife, partner, adult child, roommate, friend, etc.
Relationship to Children*
Examples: mother, father, guardian, sibling, parent figure, etc.
Phone Number*
Phone number that is used most often
Preferred Pronouns*
Race *
Hispanic / Latinx?*

YesNo
Other Adult in Household (#3)*

First and Middle Name(s)Last Name 1, Last Name 2
Date of Birth*

MonthDayYear
Social Security Number (if applicable)*
If you do not have a social security number, please write "no" in the box.
Relationship to Primary Contact*
Relationship to Children*
Phone Number*
Phone number used most often by this family member.
Preferred Pronouns*
Race *
Hispanic / Latinx?*

YesNo

Budget - Monthly Expenses
Housing Expenses
Housing Payment (rent or mortgage)*
If this is not an expense for your family, please write "0".
Utilities (gas, water, electricity)*
If this is not an expense for your family, please write "0".
Wifi / Internet*
If this is not an expense for your family, please write "0".
Cell Phones / Mobile Devices*
If this is not an expense for your family, please write "0".
Other Housing Expenses (parking, pet rent, HOA, renters insurance, etc.)*
If this is not an expense for your family, please write "0".
Food Expenses
Groceries*
If this is not an expense for your family, please write "0".
Meals Out / Delivery*
If this is not an expense for your family, please write "0".
Other Food Expenses (school lunch, etc.)*
If this is not an expense for your family, please write "0".
Transportation Expenses
Car Loan*
If this is not an expense for your family, please write "0".
Car Insurance*
If this is not an expense for your family, please write "0".
Ride Shares / Uber / Lyft / Carpooling*
If this is not an expense for your family, please write "0".
Gasoline*
If this is not an expense for your family, please write "0".
Medical Expenses
Health Insurance*
If this is not an expense for your family, please write "0".
Medications*
If this is not an expense for your family, please write "0".
Co-Pays for Medical Visits*
If this is not an expense for your family, please write "0".
Other Health Expenses (monthly payments for contacts, etc.)*
If this is not an expense for your family, please write "0".
Financial Expenses
Loan Payments (not for a car)*
If this is not an expense for your family, please write "0".
Fees for Money Orders*
If this is not an expense for your family, please write "0".
Pre-Paid Bank Cards*
If this is not an expense for your family, please write "0".
Credit Card Payments (monthly)*
If this is not an expense for your family, please write "0".
Tuition / School Fees*
If this is not an expense for your family, please write "0".
Personal & Family Expenses
Childcare / After-School Programs*
If this is not an expense for your family, please write "0".
Hygiene Products & Personal Care*
If this is not an expense for your family, please write "0".
Laundry*
If this is not an expense for your family, please write "0".
Clothing / Shoes*
If this is not an expense for your family, please write "0".
Entertainment (includes subscriptions like Hulu, Netflix, Disney+, etc.)*
If this is not an expense for your family, please write "0".
Subscriptions (DoorDash, Uber, Amazon, Instacart, etc.)*
If this is not an expense for your family, please write "0".
Money Given or Sent to Others (family, child support, etc.)*
If this is not an expense for your family, please write "0".
Additional Expenses / One-Time Upcoming Expenses

If you have any other additional expenses that you do not pay monthly, please write them here and explain what these expenses are, when you must pay them, and how often they need to be paid.
Additional Expenses
Other expenses that are not regular, but may be upcoming, include: car maintenance (oil changes, new tires, etc.), sports fees / uniforms (uniforms, games, etc.), summer camp fees, new eyeglasses that are not covered by insurance, etc.

Agreements and Understandings
I agree that this application has been completed honestly to the best of my ability.*
Type your initials or name to agree. Agreements are required.
I agree that Family Promise of Gallatin Valley assistance is NOT guaranteed. *
Type your initials or name to agree. Agreements are required.
I agree to participate in all program expectations and submit all documentation requested, in order to be eligible for FPGV assistance. FPGV is not a drop-in service and families must meet program requirements in order to continue. *
Type your initials or name to agree. Agreements are required.
I confirm that I have at least one dependent under the age of 18 years old in my primary custody (50% or more) or that I am pregnant at this time. If you are trying to find housing to reunify with your child(ren), please have your caseworker contact FPGV to confirm reunification efforts.*
Type your initials or name to agree. Agreements are required.
I agree that Family Promise of Gallatin Valley has permission to contact other organizations on my behalf, as well as receive information, in order to be eligible for FPGV assistance. (Consent for Release of Information).*
Type your initials or name to agree. Agreements are required.
I agree that if I request to participate in an on-site housing program for FPGV (examples: shelter, transitional housing, workforce housing), that FPGV can perform a background check on ALL adults over the age of 18 years old in the family unit. If an adult in my family does not have a social security number, I agree that I will get a reference from a professional in the community - FPGV staff will provide further information if this is applicable to your family. (Consent for Background Check).*
Type your initials or name to agree. Agreements are required.
Is there anything else you would like to include about your family's current situation?
Signature*

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Family Promise of Gallatin Valley - Housing Programs Application

Important Note

Thank you for your interest in Family Promise of Gallatin Valley programs. Unfortunately, you are not currently eligible for FPGV's programs. Please reach out to other resources for assistance.

Children

Thank you for your interest in Family Promise of Gallatin Valley programs. Unfortunately, you are not currently eligible for FPGV's programs. Please reach out to other resources for assistance.

Childcare & Schools

Sources of Income

Current Housing Situation

Transportation

Pets

Other Factors

Documents (Optional)

Budget - Monthly Expenses

Housing Expenses

Food Expenses

Transportation Expenses

Medical Expenses

Financial Expenses

Personal & Family Expenses

Additional Expenses / One-Time Upcoming Expenses

Agreements and Understandings