Jones Second Chance Housing: Interest Form
  • Jones Second Chance Housing (Men’s Independent Living Program)

    Jones Second Chance Housing (Men’s Independent Living Program)

    Structured Independent Shared Housing for Adult Men in Transition
  • ⚠️ Please Read Before Completing This Application

    Jones Second Chance Housing is an independent shared living program designed for adult men only.

    If you are a woman seeking housing, please apply to Jones Haven for Women:
    https://form.jotform.com/252935101060041

    If you are a woman with children seeking housing, please apply to Jones Haven for Women & Children:
    https://form.jotform.com/260314691869062

    Applications submitted for the incorrect program will be redirected.

  • Section 1: Personal Information

  •  - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Section 2: Current Situation

  •  - -
  • Section 3: Referral Information

  • Section 4: Support & Income

  • Section 5: Housing Needs

  • [Note: We do not automatically deny housing based on this information. It is used only to ensure appropriate placement and create a safe, supportive environment for all residents.]

  • Section 6: Final Questions

  • Should be Empty: