Dixon’s Breakthrough Living Solutions — Housing Waitlist
Tell us how to reach you and what housing support you need. Our team will review your request and follow up. Please do not enter Social Security numbers, ID numbers, or medical details. Questions? Email dbtlsllc@gmail.com.
Current employment status
Please Select
Employed
Self-employed
Unemployed
Seeking employment
Student
Retired or receiving benefits
Other
Current city and state
*
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Current living situation
Please Select
Homeless or unsheltered
Staying with family or friends
Shelter or temporary housing
Currently housed but need a change
Other
When do you need housing?
Please Select
As soon as possible
Within 30 days
Within 30–60 days
Within 60–90 days
Just exploring options
What support are you looking for? Select all that apply.
Safe, structured housing
Employment resources
Life skills and budgeting
Transportation assistance
Additional needs or referral information (optional)
Preferred contact method
Please Select
Email
Phone call
Text message
I understand this is a waitlist request and does not guarantee housing.
*
Yes, I understand
Submit
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