Restore Her Hope: Housing Program

Restore Her Hope: Housing Program

Housing spaces are limited to the Huntsville, AL area only. Our transitional move-in date is December 1st. We’d love to welcome you—secure your spot and join our supportive community today!
Please review the Program Overview carefully before applying.

Restore Her Hope: Housing Program Overview
Personal Information
Full Name*

First NameLast Name
Date of Birth

MonthDayYear
Date
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact*

NameTelephone Number
Section 2: Background & Current Situation
What is your current living situation? (e.g., staying with family/friends, shelter, car, transitional housing, homeless)*
How long have you been in this situation?*
What circumstances led to your current housing situation?*
Are you currently employed? (If yes, where and how many hours per week?)*
How long have you been in this situation?*
Will you be able to afford $168.75 weekly or $675 monthly? Please note that there is a nonrefundable community fee of $150 dollars.*

YesNo
Section 3: Support & Safety
Do you understand that this program provides shared living arrangements and that you will have a roommate?*

YesNo
Are you currently working with any caseworker, counselor, or social service agency?*

YesNo
Do you feel safe in your current environment?*

YesNo
Section 4: Goals & Readiness
What are your short-term goals (next 3–6 months)?*
What are your long-term goals (next 1–2 years)?*
How do you believe the Restore Her Hope Housing Program can help you?*
Are you willing to participate in coaching, mentorship, or life skills programs while in housing?*
Do you have specific areas where you’d like support (e.g., job readiness, parenting, budgeting, healing, faith)?*
Section 5: Household Needs
Do you have transportation?*

YesNo
Do you have any medical conditions or disabilities we should be aware of to best accommodate you?*
Section 6: Additional Information

Please provide two references.*

Rows	Full Name	Contact Number	Relation (e.g.,friend, mother, brother)
1
2

Please upload your paystubs for August and September to verify income. *

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File Upload*

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File Upload

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File Upload

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Consent & Acknowledgment

I confirm that the information provided is true and complete. I understand that providing false information may affect my eligibility for housing.
Should be Empty:

Restore Her Hope: Housing Program

Personal Information

Section 2: Background & Current Situation

Section 3: Support & Safety

Section 4: Goals & Readiness

Section 5: Household Needs

Section 6: Additional Information

Consent & Acknowledgment