Emergency Shelter Application

Our shelters operate for 22 weeks between 4th November 2019 and 6th April 2020. Glass Door uses the information you provide on this form in order to offer you a place in our night shelter. We also use demographic information to determine the need for our service and to inform future planning. We will never sell or share your information with other organisations for marketing purposes. For more information please see our privacy policy.

Note: Referrals expire after 7 days due to the number of referrals we receive. If you do not hear back in seven days, either call the office on 02080166838 or re-submit your referral form using the same name to refresh your space on the waiting list.

Please let us know which area(s) you would be happy to go to for shelter. Rate the area in order of preference 1 being most wanted and 4 being least wanted. If you are happy to have shelter anywhere, please put 1 for every area. We will try to offer you a space in the area you want most but please remember that due to high demand this is not always possible.