Get Wait List Referral Form - Carrfour Supportive Housing

Filling out the Wait List Referral Form for Carrfour Supportive Housing is an essential step in the referral process for supportive housing. This guide provides clear and detailed instructions on how to complete the form online, ensuring your submission is accurate and complete.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the date of referral at the top of the form. This is crucial for tracking the application.
3. Enter the personal information of the Head of Household (HOH), including first name, last name, gender, date of birth, and place of birth.
4. Provide the last four digits of the Social Security Number and the HMIS number if applicable.
5. Input the applicant’s primary phone number and an alternate phone number for contact purposes.
6. Include the applicant’s email address to facilitate communication.
7. Indicate employment status by answering if they are employed with 'Y' for Yes or 'N' for No.
8. State whether the applicant is receiving any monetary benefits like SSI, SSDI, or TANF by using 'Y' or 'N.'
9. Input the total monthly household income as a numerical value.
10. Answer whether the applicant has experienced homelessness or shelter stays four or more times in the past three years with 'Y' or 'N.'
11. Identify the current living situation by checking the appropriate box, specifying the name of the shelter or program if applicable.
12. Indicate if the Head of Household qualifies as having a disability or related conditions using 'Y' or 'N.'
13. Confirm if the Head of Household is receiving (or pending) SSI or SSDI benefits with 'Y' or 'N.'
14. Determine if any child in the household qualifies as having a disability and is receiving SSI or SSDI benefits.
15. Sign the form to certify that all provided information is accurate, including your printed name and phone number.
16. Ensure to submit a copy of a business card with the application.
17. Finally, save your changes, and you may choose to download, print, or share the completed form.

Complete your Wait List Referral Form online today and take the next step toward supportive housing.