Housing Inquiry
  • Housing Inquiry

    Housing Inquiry

    Congratulations on taking a step toward housing and financial stability for your family. Please complete and submit this secure form. The information you provide will be used to determine if Family Renew Community has the right program for you.
  • Date of Birth*
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  • Are you a Volusia/Flagler County resident?*
  • Marital Status*

  • Family Members Seeking Housing*

  • Which Family Renew Community residential campus would you prefer?*

  • For the remainder of this form, "you" refers to the person filling out the form. "Spouse" refers to the other adult in the family seeking housing, if any, regardless of marital status.

  • Are you pregnant?*
  • Is your spouse pregnant?
  • Spouse's Date of Birth
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  • Are there children in your household under the age of 18?*
  • Do you have custody of the children?*
  • Are you currently working?*
  • Is your spouse currently working?
  • Have you ever been in a drug/alcohol treatment program?*
  • Type of program?
  • Has your spouse ever been in a drug/alcohol treatment program?
  • Type of program?
  • Have you ever been in a shelter/transitional housing?
  • Have you ever been arrested?
  • If yes, have there been any felony arrests in the last three years?
  • Has your spouse ever been arrested?
  • If yes, have there been an felony arrests in the last three years?

  • Please list the amounts your household receives per month of any of the following:

    All fields are mandatory. If it does not apply type 0 or N/A.
  • Should be Empty: