Homeless Housing Shelter Referral & Community Resource Connections 
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    COMMUNITY RESOURCE CONNECTIONS

    Please allow 24-48 hours, Monday-Thursday, for a response. We are closed on the weekends. All submissions received on a weekend will be responded to on Monday mornings.

  • Date*
     - -

  • Are you needing to flee from domestic violence?

    If they answer "YES" give them the resources below as we are unable to provide resources for domestic violence situations at this time.

    API-CHAYA (206) 325-0325

    Snohomish County DV Services (425) 252-2873

     

    (NO NEED TO FILL OUT THE FORM. END HERE)

  • Head of Household Information

  •  -

  • Household Information 

  • Is anyone pregnant?
  • Do you have pets?
  • Have you contacted NorthSound 211 for Coordinated Entry Services? We will connect them with one when a housing team member calls them.*
  • Are you currently employed or receiving cash benefits?*

  • Community Resource Connection

  • Are you in need of connecting to community resources?

  • For students and their families of the Everett Public Schools there may be additional resources and/or referrals if you have a child actively attending in a Everett Public School. We do need to verify they are enrolled by asking for their name, school they attend, and student ID number. 

     

    (Proceed to next Question)

  • FYI ONLY

    EVERETT PUBLIC SCHOOLS LIST

    If their child(ren) does not attend any of the schools below put in notes which school they attend. Thank you.

    ELEMENTARY SCHOOLS

    • Cedar Wood
    • Emerson
    • Forest View
    • Garfield
    • Hawthrone
    • Jackson
    • Jefferson
    • Lowell
    • Madison
    • Mill Creek
    • Monroe
    • Penny Creek
    • Silver Firs
    • Silver Lake
    • Tambark Creek
    • View Ridge
    • Whittier
    • Woodside

    MIDDLE SCHOOL

    • Eisenhower
    • Evergreen
    • Gateway
    • Heatherwood
    • North 

    HIGH SCHOOL

    • Cascade
    • Everett
    • Henry M. Jackson
    • Sequoia
  • Are you okay with us sharing your name, contact information, and current need with our community partners?

  • RELEASE OF INFORMATION 

    We will need a release of information to share your information and need with our community partners. I will send you an email with a link to it. Our housing team will not be able to assist your until the release of information is submitted. 

    Send the caller an email with a link to our Release of Information. You can save the link below to your desktop pressing CONTROL key and clicking on the link at the same time. Then, select SAVE LINK AS or, you can copy and paste the link below to add to the email you send them. 

     

    LINK: 

     

    https://form.jotform.com/202044969831055

     

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