Housing Ministry

Opening Doors For You

Our mission is to provide housing security for people who need it most. Use this form to apply for a private or semi-private room in one of our active markets. If your area is not listed, we will do our best to assist with placement.

Instructions: Please complete all sections of the form below. A representative from a participating home will contact you within 24 hours to discuss room availability or to add you to the waitlist.

NOTICE

You must be over 18 years old to apply for housing.

Each application is reviewed individually.
INDEPENDENT LIVING ACKNOWLEDGEMENT. This housing is for adults who are able to live on their own. We do not provide medical, nursing, or personal care services. To qualify, you must be able to meet your daily needs (such as meals, bathing, medications, and transportation) without on-site assistance. Are you able to live safely and independently without support services?
Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
How did you find us?
Preferred Move In Date
Amount of Monthly Income
Can you verify income source? (Paystub, Award Letter, etc.?)
Where are you seeking to live?
Do you need public transportation?
Reason for Seeking Housing/Introduction
Placement Questions [Optional]

These questions are not required but help us connect you with homes that honor certain communities or preferences. Checking a box will never disqualify you.
Age [OPTIONAL]
Sex [OPTIONAL]
Click All That Apply
Non-Discrimination Statement

We comply with the Fair Housing Act and do not discriminate based on race, color, religion, sex, disability, familial status, national origin, or any other protected class. A history of justice involvement or probation does not automatically disqualify you; each case is considered individually.

Consent and Privacy Notice

By submitting this form, you authorize Housing Ministry and participating providers to contact you by phone, text, or email only for the purposes of reviewing your application and helping fulfill your housing request.

Your information will be kept confidential and used solely for housing placement purposes.
Should be Empty:

Placement Questions [Optional]