Follow the steps to successfully complete the application.

1. Select the ‘Get Form’ button to access the application and open it in an online editing tool.
2. Begin by entering your personal details in the 'Name' field, followed by your 'Admission Date' and 'Release Date.' Ensure this section is clear and accurate.
3. Provide your permanent address, including city, state, and ZIP code. Additionally, indicate if you have previously resided in Catawba, Burke, Alexander, or Caldwell Counties by checking 'Yes' or 'No.'
4. Fill in your contact information by entering your home and work telephone numbers.
5. Enter your age, birth date, sex, race, and religion in the respective fields, making sure to provide accurate information.
6. Indicate your marital status and provide your maiden name if applicable.
7. State your current occupation and whether you consider yourself able-bodied or disabled. If disabled, specify the amount of disability benefits received.
8. Confirm if you have Medicaid and indicate if you are a U.S. veteran, as well as the branch of service if applicable.
9. Answer the questions regarding your homelessness history, including if you have ever been homeless and the number of times this has occurred.
10. Fill in the children’s information if applicable, including their names and ages, as well as their current school enrollment status.
11. Complete the emergency contact information by listing the name, address, and phone number of an emergency contact, along with their relationship to you.
12. Detail any completed rehabilitation programs and your current rehabilitation program details, including the counselor's name and contact information.
13. Carefully respond to the medical history section, indicating any relevant medical conditions and all prescribed medications.
14. Complete the mental health history section with any previous mental health involvement and current medication usage if applicable.
15. Address any legal concerns by indicating if you have been convicted of a crime and providing details of such cases.
16. Answer miscellaneous questions, including admission fees and identification details.
17. Finalize your application by reading through the application to ensure accuracy and completeness. Once satisfied, save your changes, download, and/or print the application form for your records.

Complete your application online today to take the first step towards residency at Exodus Homes.