Please complete this form to be added to our waiting list

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Head of Household Information




Make sure this is correct.
We cannot reach you without a phone number.


DD/MM/YYYY

17 years old and younger

5B, 2G = Five-year-old boy, two-year-old girl

Anyone over 18-years-old is considered an adult
2nd Adult Info




Grandmother, spouse, son, etc


3rd Adult Info






4th Adult Info





Your Situation
Please tell us in as much detail as possible.
The more information you give us, the better.


Car? Streets? Couch surfing? With family?


Our Shelter
About Our Shelter And Program
Our Mission:
To end family homelessness in our community.

Our Vision:
Every family has a place to call home.


Family Supportive Housing is not just a shelter, we are also a program.

In our shelter, we cover your family's basic needs: a safe, studio-sized room for only your family with bathroom, food, and clothing.

In our program, you get a case manager, a staff member dedicated to helping your family get out of homelessness.

For more information about our program, click here.



At least one child MUST be sleeping in our shelter a minimum of 4-nights a week

Sorry, we do not allow emotional support animals in the shelter for any reason.

We do not allow pets in our shelter. You will need to find a place for your pet.
Click here for the Humane Society Emergency Pet Boarding Services



Vegan? Vegetarian? Developmental disabilities?




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ATTENTION:
IMPORTANT WAITLIST
INFORMATION BELOW


If you need shelter,
please read and follow
the instructions below carefully:

TAKE A SCREENSHOT OF THESE INSTRUCTIONS:


How to check into our waiting list:
Send a text daily with your full name to
Kevin at (408) 516-5117
From 10 AM - 11 AM
Monday - Friday

or

Call (408) 926-8885 
From 10 AM - 11 AM
Monday - Friday

We will reach out to you when we
have a room for your family.

But you need to check in with us daily.



Organizations who are also committed to helping families
Resources on the next page