Jones Haven for Men & Children Interest Form
Share your contact details, household info, goals, and needs for the shared-living housing waitlist.
Important Information
What This Program Is
Jones Haven for Men & Children is structured independent shared living for adult men with dependent children. It is not emergency shelter, childcare, assisted living, treatment, or supervised housing.
Living Arrangements
Residents receive a private furnished bedroom for the adult and children, with shared kitchen, bathrooms, laundry, and common spaces. Utilities and Wi‑Fi are included. Adult residents are responsible for their children’s care and supervision at all times. There are no on-site staff.
Service Area
Service areas include New Castle County, DE; Cecil County, MD; and Delaware County, PA. Availability is not guaranteed, and there is no promise of current openings.
Pricing
• Adult: $950/month
• Each child: $250/month
• One-time community fee: $200
• Example: Adult + 1 child = $1,200/month and $1,400 standard move-in
• Example: Adult + 2 children = $1,450/month and $1,650 standard move-in
Monthly program fees are prorated for move-ins after the 5th. The one-time community fee is not prorated. Approved move-in costs must be paid before occupancy.
Eligibility & House Rules
Applicants must have verifiable employment, benefits, or an approved sponsor, show the ability to live independently, remain drug- and alcohol-free, follow shared household rules, complete cleaning chores, have no overnight guests, follow visitor restrictions, supervise children, and respect shared spaces. Accessibility needs are assessed individually.
Interest / Waitlist Only
This application is for interest and waitlist consideration only. It does not guarantee placement or immediate housing. Intake will contact applicants when suitable opportunities become available, and no onboarding documents are collected at the waitlist stage.
Next Steps
If your household may be a fit, please complete the form below. For questions, contact intake at
302-842-3356
or
intakejoneshousing@gmail.com
.
Adult Male Applicant's Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Date of Birth
*
Please select a month
January
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Day
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01111
Year
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
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Algeria
American Samoa
Andorra
Angola
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The Bahamas
Bahrain
Bangladesh
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Belize
Benin
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Bhutan
Bolivia
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Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
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Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
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El Salvador
Equatorial Guinea
Eritrea
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Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
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Guadeloupe
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Iran
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Laos
Latvia
Lebanon
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Liberia
Libya
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Lithuania
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Macedonia
Madagascar
Malawi
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Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
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Niger
Nigeria
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Turkish Republic of Northern Cyprus
Northern Mariana
Norway
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Pakistan
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Panama
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Paraguay
Peru
Philippines
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Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
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Turks and Caicos Islands
Tuvalu
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United Arab Emirates
United Kingdom
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Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
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Isle of Man
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Wallis and Futuna
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Other
Country
Preferred Contact Method
*
Phone
Email
Text message
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Have you applied to Jones Haven before?
*
Yes
No
Current Housing Need and Reason
*
Child Household Composition and Ages
*
Income Sources
*
Employment
Benefits
Child support
Family support
Third-party funding
Other
Other
Current Employment Status
*
Employed full-time
Employed part-time
Self-employed
Unemployed
Retired
Other
Other
Do you have third-party funding?
*
Yes
No
Case Manager Details
Do you have transportation?
*
Yes
No
Are you willing to share common areas with other families?
*
Yes
No
Can you live independently?
*
Yes
No
Can you supervise your children and follow chores and house rules?
*
Yes
No
Reasonable Accommodation Needs
Housing Stability Goals
*
Steps Already Taken and Support Needed
*
Do you understand there is no on-site childcare or staff?
*
Yes
No
Do you understand this is a waitlist only application and availability is not guaranteed?
*
Yes
No
Will you monitor email for updates?
*
Yes
No
Number of Children
*
Children's Information
*
Current Housing Situation
*
Staying with friends/family
Shelter
Transitional housing
Currently unhoused
Other
Desired Move-In Timeline
*
Please Select
As soon as possible
Within 1 month
1-3 months
3-6 months
6+ months
Current Employment Status
*
Employed full-time
Employed part-time
Unemployed
Other
Monthly Household Income (approximate)
*
Do you have a case manager or support worker?
*
Yes
No
Case Manager or Support Worker Name
Case Manager or Support Worker Contact Info
What are your expectations for independent living and sharing a household?
*
Please list any accommodation needs (e.g., accessibility, dietary, medical, etc.)
*
What are your goals for housing stability?
*
Submit Interest Form
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