2021-2022 Night Shelter - Emergency Shelter Application

Page 1

Our shelters operate for around 22 weeks during the Winter months.
  • The shelters are in a different church venue each day of the week and you will be provided with a map on entry. All venues are local to each other. 
  • You will be sharing a space with other guests, men and women sleep in different areas.  If you are in the male sleeping area, you will share with around 20 others. The female area will host around 3 people. We provide sleeping bags and mats for use on the floors of the church halls. 
  • You must be either fully vaccinated or willing to be fully vaccinated at least 14 days before you join the shelter. This is because of the inherent risk presented by COVID-19 associated with shared space. The COVID-19 vaccines are the best way to protect yourself and others.
  • You must not be considered vulnerable to COVID-19 in order to join the shelter. COVID-19 can make anyone seriously ill, but for those considered vulnerable, the risk is higher. Vulnerabilities are listed below. If you are deemed vulnerable, please come to one of our partner day centres to speak to a caseworker regarding alternative winter provisions.
  • We have put measures in place so that we can best ensure our guests safety from Covid-19 and rules around social distancing will apply. 
  • All guests must follow our golden rules to stay in the shelters, failure to do so will result in a loss of place. Golden rules include things like being respectful to others, and no alcohol or drugs in the service. Staff will be available at all times.
  • You must attend every night (unless previously agreed with a member of staff) or your place will be taken by another guest.
  • The service opens at 7:15pm, and you must arrive by 8pm unless previously agreed with a manager.
  • A hot meal is served at 8pm, and breakfast is provided in the morning.  Everyone leaves the venue at 7am for the church to resume its normal activities.
  • You will be provided with information about local day centres where you can receive lunch, showers, and laundry services.

Please only fill in this form 
if you have no known Covid-19 health vulnerabilities (listed below) and are either, fully vaccinated or willing to be fully vaccinated before you join the shelter.

Covid-19 vulnerabilities:
Aged 60 or over, Asthma/COPD, Heart attack/Stroke/Angina/Chest Pain, High Blood Pressure, Diabetes, Chronic Kidney problem (eg. UTI), Chronic Liver Problems (eg. Hepatitis), Severe brain disorder, Pregnant, HIV positive, Sickle cell disease, Cancer, Was asked to shield by their GP in 2020

For those that are deemed clinically vulnerable, please come to one of our partner day centres to speak to a caseworker regarding alternative winter provisions.

Data Protection Statement
Glass Door uses the contact information you provide on this form in order to offer you a place in our night shelter. We use the vaccination and health vulnerability information as we believe it is our legitimate interest to ensure all guests, employees and volunteers are kept safe from Covid-19. You have the right to object to this processing at any time. We use demographic and current circumstance information to; determine your best route of homelessness, the need for our service and to inform future planning. Information will not be kept longer than is necessary and will be stored in accordance to our Data Protection Policy.  For more information please see our privacy policy on our website.


Page 2












You must not be considered vulnerable to COVID-19 in order to join the shelter. COVID-19 can make anyone seriously ill, but for those considered vulnerable, the risk is higher. Vulnerabilities are listed below. If you are deemed vulnerable, please come to one of our partner
 day centres to speak to a caseworker regarding alternative winter provisions.













This information will be used to contact you in the event we cannot contact the guest. Please only list your details if you are happy to be contacted for this purpose





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.