Intake form

Name *

Email address *

What type of assistance are you seeking?

Please select at least one option.

Housing Stabilization

Financial Empowerment

Community Resources

Workforce Housing

Family Support

Are you currently experiencing housing instability?

How many individuals are in your household?

What is your current living situation?

Please select at least one option.

Renting

Homeless

Living with family/friends

Subsidized housing

What is your preferred method of communication?

Do you have any specific needs or requirements?

Which service or services are you interested in?

Please select at least one option.

Housing Stabilization Services: Connecting People to Resources

Community Resource Navigation

Financial empowerment resources

Additional questions or comments

The Community HUB The Bridge to Housing Stability