Journey to Housing Program
Mission Statement
To witness to the Gospel as we accompany families in Western Wayne County on their journey to housing and to self-sufficiency.
Values
Witness to the Gospel - by our speech and our actions we attest to the truth of the Gospel.
Commitment to the Families Experiencing Homelessness. We stand with and accompany families on their journey to housing.
Reverence - We honor the sacredness and dignity of each person.
Affiliation with the Society of St. Vincent de Paul - We respect and value our affiliation with the Society of St. Vincent de Paul.
Stewardship - We hold ourselves accountable to the resources entrusted to our care.
Journey to Housing Program Description:
The Journey to Housing (JTH) Program is a Catholic Ministry under St. Vincent DePaul Detroit that helps homeless families living or working in Western Wayne County obtain a place to call home. The goal is to help families learn life-long strategies that result in stable housing for the future.
JTH requires the families to consistently participate in our Financial Wellness and Family Support Programs. Most families go thru the program in 6-9 months. But the speed with which you are housed is dependent on how quickly you can work thru the goals. JTH is not emergency assistance nor do we help with past rent amounts owed.
If all participation requirements are met, and the family has completed the program, JTH has many resources to help with transitioning to a home. Those resources may include future rent assistance, move-in costs like security deposit , and household furnishings.
You must be able to participate in services in these areas to be considered eligible for our program. Which means you will need to be currently living, working or your kids are in school in one of these areas.
Canton, Dearborn, Dearborn Heights, Garden City, Inkster, Livonia, Northville, Plymouth, Redford, the City of Wayne (zip code 48184), and Westland
The following are requirements for preliminary screening into the Journey to Housing Program:
- Able to participate in services in one of the above-mentioned cities meaning: You work in this area; You are currently living in this area; Your support system is in this area; etc. Please note that we only house folks in the cities listed above.
- Living in a condition of homelessness with at least one child under the age of 18. Homelessness is defined as living in a motel, shelter, car, on the street or with a family member or friend.
- Sufficient income to meet rental housing costs.
- Pass a drug test and criminal background check before acceptance
- Provide credit reports for application and throughout the process. Note: Journey's will help guide you through the credit repair process
If you are still interested in our program please proceed below.
Directions:
Please read the above program description. If you feel that you qualify and are interested in our program please fill out the information below.
Your First name and Last Name:
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{"type":"text","name":"__generic2","width":12,"value":"","size":"Normal","validation":"TI","validationMessage":"Please fill in this item.","placeholder":"Age"}
{"type":"text","name":"__generic3","width":25,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":"Date of Birth "}
Sex:
{"type":"radio","name":"__generic","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Male\nFemale"}
Your Marital Status SelectSingleMarried and Living TogetherMarried but no longer living together DivorcedNot Legally Married but Living Together{"type":"select","name":"__generic4","width":50,"value":"","size":"Normal","validation":"N1","validationMessage":"Please make a selection for this item.","options":"Select\nSingle\nMarried and Living Together\nMarried but no longer living together \nDivorced\nNot Legally Married but Living Together"}
Spouse/Significant Other:
Please list their name below ONLY if you would like to be housed with them in the future:
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{"type":"text","name":"__generic6","width":12,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":"Age"}
{"type":"text","name":"__generic7","width":25,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":"Date of Birth "}
Sex:
{"type":"radio","name":"__generic","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Male\nFemale"}
Children:
Our program requires children/dependents under the age of 18 and that you have legal custody of those children. Do you have children/dependents under the age of 18 and legal custody?
{"type":"radio","name":"__generic8","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}
If yes please list below:
Child's
Last Name
| Child's
First Name
| Date of Birth
| Sex | Age
| Applicant has Legal Custody | City of School Attendance |
|---|
{"type":"text","name":"__generic21","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Our program requires children, please fill in this item if you are eligible.","placeholder":""}
| {"type":"text","name":"__generic22","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Our program requires children, please fill in this item if you are eligible.","placeholder":""}
| {"type":"text","name":"__generic23","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Our program requires children under 18 please fill in this item if you are eligible.","placeholder":""}
| SelectMF{"type":"select","name":"__generic24","width":100,"value":"","size":"Small","validation":"N1","validationMessage":"Our program requires children please fill in this item if you are eligible.","options":"Select\nM\nF"}
| {"type":"text","name":"__generic25","width":100,"value":"","size":"Small","validation":"TI","validationMessage":"Our program requires children under 18 please fill in this item if you are eligible.","placeholder":""}
| SelectYN{"type":"select","name":"__generic26","width":100,"value":"","size":"Small","validation":"N1","validationMessage":"Please make a selection for this item.","options":"Select\nY\nN"}
| SelectCantonDearbornDearborn HeightsGarden CityInksterLivoniaNorthvillePlymouthRedfordWestlandOnline SchoolHomeschooled Not School Age Other{"type":"select","name":"__generic9","width":100,"value":"","size":"Small","validation":"N1","validationMessage":"Please make a selection for this item.","options":"Select\nCanton\nDearborn\nDearborn Heights\nGarden City\nInkster\nLivonia\nNorthville\nPlymouth\nRedford\nWestland\nOnline School\nHomeschooled \nNot School Age \nOther"}
|
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| {"type":"text","name":"__generic29","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| {"type":"text","name":"__generic30","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| SelectMaleFemale{"type":"select","name":"__generic31","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please make a selection for this item.","options":"Select\nMale\nFemale"}
| {"type":"text","name":"__generic32","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| SelectYN{"type":"select","name":"__generic33","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please make a selection for this item.","options":"Select\nY\nN"}
| SelectCantonDearbornDearborn HeightsGarden CityInksterLivoniaNorthvillePlymouthRedfordWestlandOnline SchoolHomeschooled Not School Age Other{"type":"select","name":"__generic10","width":100,"value":"","size":"Small","validation":"N1","validationMessage":"Please make a selection for this item.","options":"Select\nCanton\nDearborn\nDearborn Heights\nGarden City\nInkster\nLivonia\nNorthville\nPlymouth\nRedford\nWestland\nOnline School\nHomeschooled \nNot School Age \nOther"}
|
{"type":"text","name":"__generic35","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| {"type":"text","name":"__generic36","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| {"type":"text","name":"__generic37","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| SelectMaleFemale{"type":"select","name":"__generic38","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please make a selection for this item.","options":"Select\nMale\nFemale"}
| {"type":"text","name":"__generic39","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| SelectYN{"type":"select","name":"__generic40","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please make a selection for this item.","options":"Select\nY\nN"}
| SelectCantonDearbornDearborn HeightsGarden CityInksterLivoniaNorthvillePlymouthRedfordWestlandOnline SchoolHomeschooled Not School Age Other{"type":"select","name":"__generic11","width":100,"value":"","size":"Small","validation":"N1","validationMessage":"Please make a selection for this item.","options":"Select\nCanton\nDearborn\nDearborn Heights\nGarden City\nInkster\nLivonia\nNorthville\nPlymouth\nRedford\nWestland\nOnline School\nHomeschooled \nNot School Age \nOther"}
|
{"type":"text","name":"__generic42","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| {"type":"text","name":"__generic43","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| {"type":"text","name":"__generic44","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| SelectMaleFemale{"type":"select","name":"__generic45","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please make a selection for this item.","options":"Select\nMale\nFemale"}
| {"type":"text","name":"__generic46","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| SelectYN{"type":"select","name":"__generic47","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please make a selection for this item.","options":"Select\nY\nN"}
| SelectCantonDearbornDearborn HeightsGarden CityInksterLivoniaNorthvillePlymouthRedfordWestlandOnline SchoolHomeschooled Not School Age Other{"type":"select","name":"__generic12","width":100,"value":"","size":"Small","validation":"N1","validationMessage":"Please make a selection for this item.","options":"Select\nCanton\nDearborn\nDearborn Heights\nGarden City\nInkster\nLivonia\nNorthville\nPlymouth\nRedford\nWestland\nOnline School\nHomeschooled \nNot School Age \nOther"}
|
{"type":"text","name":"__generic49","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| {"type":"text","name":"__generic50","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| {"type":"text","name":"__generic51","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| SelectMaleFemale{"type":"select","name":"__generic52","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please make a selection for this item.","options":"Select\nMale\nFemale"}
| {"type":"text","name":"__generic53","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| SelectYN{"type":"select","name":"__generic54","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please make a selection for this item.","options":"Select\nY\nN"}
| SelectCantonDearbornDearborn HeightsGarden CityInksterLivoniaNorthvillePlymouthRedfordWestlandOnline SchoolHomeschooled Not School Age Other{"type":"select","name":"__generic13","width":100,"value":"","size":"Small","validation":"N1","validationMessage":"Please make a selection for this item.","options":"Select\nCanton\nDearborn\nDearborn Heights\nGarden City\nInkster\nLivonia\nNorthville\nPlymouth\nRedford\nWestland\nOnline School\nHomeschooled \nNot School Age \nOther"}
|
{"type":"text","name":"__generic56","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| {"type":"text","name":"__generic57","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| {"type":"text","name":"__generic58","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| SelectMaleFemale{"type":"select","name":"__generic59","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please make a selection for this item.","options":"Select\nMale\nFemale"}
| {"type":"text","name":"__generic60","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| SelectYN{"type":"select","name":"__generic61","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please make a selection for this item.","options":"Select\nY\nN"}
| SelectCantonDearbornDearborn HeightsGarden CityInksterLivoniaNorthvillePlymouthRedfordWestlandOnline SchoolHomeschooled Not School Age Other{"type":"select","name":"__generic14","width":100,"value":"","size":"Small","validation":"N1","validationMessage":"Please make a selection for this item.","options":"Select\nCanton\nDearborn\nDearborn Heights\nGarden City\nInkster\nLivonia\nNorthville\nPlymouth\nRedford\nWestland\nOnline School\nHomeschooled \nNot School Age \nOther"}
|
{"type":"text","name":"__generic63","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| {"type":"text","name":"__generic64","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| {"type":"text","name":"__generic65","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| SelectMaleFemale{"type":"select","name":"__generic66","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please make a selection for this item.","options":"Select\nMale\nFemale"}
| {"type":"text","name":"__generic67","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| SelectYN{"type":"select","name":"__generic68","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please make a selection for this item.","options":"Select\nY\nN"}
| SelectCantonDearbornDearborn HeightsGarden CityInksterLivoniaNorthvillePlymouthRedfordWestlandOnline SchoolHomeschooled Not School Age Other{"type":"select","name":"__generic15","width":100,"value":"","size":"Small","validation":"N1","validationMessage":"Please make a selection for this item.","options":"Select\nCanton\nDearborn\nDearborn Heights\nGarden City\nInkster\nLivonia\nNorthville\nPlymouth\nRedford\nWestland\nOnline School\nHomeschooled \nNot School Age \nOther"}
|
Will all the children listed above be living with you at your new address?
{"type":"textarea","name":"__generic17","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":"Please type why the children will not be living with you or type N/A if they will be living with you. "}
Do you have any children over the age of 18 that you would like to live with you?
{"type":"radio","name":"__generic","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}
Please list their name, date of birth and sex below:
{"type":"text","name":"__generic","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item or type- \"N/A\" ","placeholder":""}
Have you had any involvement with CPS (Child Protective Services):
If you mark "yes or "yes-but ex-partner) please list the details of what happened and when the case was closed:
{"type":"radio","name":"__generic18","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo\nYes-but over ex-partner"}
{"type":"textarea","name":"__generic19","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Type N/A if you listed no above. ","height":80,"placeholder":"Please type details about your CPS Case or type n/a if you haven't had a CPS Case"}
Homelessness:
Our program requires that you are homeless. We define homelessness as living in a motel, shelter, car/RV, on the street or with a family member or friend.
Are you homeless?
{"type":"radio","name":"__generic20","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo- but will be evicted in next 15 days\nNo- I don't qualify for the program"}
What are the circumstances that led you to being homeless:
{"type":"textarea","name":"__generic27","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}
How long have you been homeless?
{"type":"text","name":"__generic34","width":15,"value":"","size":"Small","validation":"TI","validationMessage":"Please fill in this item.","placeholder":""}
# of Days
{"type":"text","name":"__generic41","width":15,"value":"","size":"Small","validation":"TI","validationMessage":"Please fill in this item.","placeholder":""}
# of Months
{"type":"text","name":"__generic48","width":15,"value":"","size":"Small","validation":"TN","validationMessage":"Please fill in this item.","placeholder":""}
# of Years
Where are you living now?
{"type":"checkbox","name":"__generic55","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please check at least one item.","options":"Family\nFriends \nVehicle\nCamper \nMotel/Hotel \nShelter\nNot Homeless"}
Which city do you live in today or what city did you stay last night:
{"type":"radio","name":"__generic62","width":100,"value":"","size":"Small","validation":"C1","validationMessage":"Please choose one of the above options.","options":"Canton\nDearborn\nDearborn Heights\nGarden City\nInkster\nLivonia\nNorthville\nPlymouth\nRedford\nWestland\nOther- I don't qualify based on the city I am currently living in."}
Which city do you use for your mailing address:
{"type":"radio","name":"__generic69","width":100,"value":"","size":"Small","validation":"C1","validationMessage":"Please choose one of the above options.","options":"Canton\nDearborn\nDearborn Heights\nGarden City\nInkster\nLivonia\nNorthville\nPlymouth\nRedford\nWestland\nOther"}
Our service area is: Canton, Dearborn, Dearborn Heights, Garden City, Inkster, Livonia, Northville, Plymouth, Redford, the City of Wayne (zip code 48184), and Westland. Are you willing to be housed in our service area?
{"type":"radio","name":"__generic70","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}
Section 8 Voucher- Do you have a Section 8 Voucher?
{"type":"radio","name":"__generic71","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}
If you said yes to a section 8 voucher, please list the details below, we would need the cities you can live in as well as when your voucher is going to expire:
{"type":"textarea","name":"__generic72","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":"type n/a if you don't have a Section 8 Voucher"}
Employment
Which city do you work in:
{"type":"radio","name":"__generic73","width":100,"value":"","size":"Small","validation":"C1","validationMessage":"Please choose one of the above options.","options":"Canton\nDearborn\nDearborn Heights\nGarden City\nInkster\nLivonia\nNorthville\nPlymouth\nRedford\nWestland\n100% Remote Worker\nOther- I don't qualify based on the city I am currently working in.\nOther- I work in a city that borders your service area and my job is within 5 miles of your service area.\nOther- I don't currently qualify as I am not employed."}
Your Current Employment: Please use the boxes below to fill out YOUR current employment. We require sufficient income for rental housing rates to be accepted into our program. If you are not employed and your SSD/SSI/FOOD amount is not sufficient then you will be given that as a first step of your Journey to Housing.
Your Current Employer Name and Position
| Street Address including City and Zip
| Start Date
| # of hours working per week
| Current Wage
|
|---|
{"type":"textarea","name":"__generic74","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item ","height":40,"placeholder":"Employer Name "}
{"type":"textarea","name":"__generic75","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"Please fill in this item ","height":40,"placeholder":"Position Title "}
| {"type":"textarea","name":"__generic77","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item ","height":80,"placeholder":""}
| {"type":"text","name":"__generic84","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"If you are not employed, please type \"none.\" ","placeholder":""}
| {"type":"text","name":"__generic85","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"If you are not employed, please type \"none.\" ","placeholder":""}
| {"type":"text","name":"__generic86","width":100,"value":"","size":"Small","validation":"NE","validationMessage":"If you are not employed, please type \"none.\" ","placeholder":""}
|
{"type":"textarea","name":"__generic76","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item ","height":40,"placeholder":"Employer #2 Name "}
{"type":"textarea","name":"__generic78","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item ","height":40,"placeholder":"Position Title "}
| {"type":"textarea","name":"__generic79","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item ","height":80,"placeholder":""}
| {"type":"text","name":"__generic89","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| {"type":"text","name":"__generic90","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
| {"type":"text","name":"__generic91","width":100,"value":"","size":"Small","validation":"","validationMessage":"Please fill in this item.","placeholder":""}
|
Have you listed the full mailing address of where you work? We use this address to determine if you work close enough to our service area to be considered eligible for our program:
{"type":"radio","name":"__generic80","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes the full street address is listed above including street, city and zip \nNo"}
Does your Spouse/Significant Other have income?
{"type":"radio","name":"__generic81","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please choose one of the above options.","options":"Yes- I listed it as Employer #2 above\nYes- I haven't listed it please contact me for the information \nNo- I don't have a spouse/significant other that will be living with me. \nNo- they don't work."}
PRELIMINARY FINANCIAL INFORMATION
Income Sources: Please list the amount of money YOU receive from each source per month. So if you get paid every other week you need to add both paychecks together before entering it below. If you don't receive any money from that amount please type $0.
Bridge Card for Food:
{"type":"text","name":"Inc1","width":25,"value":"","size":"Normal","validation":"TI","validationMessage":"Please fill in this item. If you receive no monies from this source please type 0 ","placeholder":"$ Per Month "}
Income from Job #1
{"type":"text","name":"Inc2","width":25,"value":"","size":"Normal","validation":"TI","validationMessage":"Please fill in this item. If you receive no monies from this source please type 0 ","placeholder":"$ Per Month "}
Income from Job #2
{"type":"text","name":"Inc3","width":25,"value":"","size":"Normal","validation":"TI","validationMessage":"Please fill in this item. If you receive no monies from this source please type 0 ","placeholder":"$ Per Month "}
Income from SSI/SSD
{"type":"text","name":"Inc4","width":25,"value":"","size":"Normal","validation":"TI","validationMessage":" If you receive no monies from this source please type 0 ","placeholder":"$ Per Month "}
Child Support:
{"type":"text","name":"Inc5","width":25,"value":"","size":"Normal","validation":"TI","validationMessage":"Please fill in this item. If you receive no monies from this source please type 0 ","placeholder":"$ Per Month "}
Other Income Such as Door Dash, Amazon Flex, Side Business Etc
{"type":"text","name":"Inc6","width":25,"value":"","size":"Normal","validation":"TI","validationMessage":"Please fill in this item. If you receive no monies from this source please type 0 ","placeholder":"$ Per Month "}
Total Income per month (This is calculated for you):
{"type":"computed","name":"__generic82","width":15,"value":"","size":"Normal","validation":null,"validationMessage":null,"formula":"Inc1+Inc2+Inc3+Inc4+Inc5+Inc6","hidden":false}
If you listed a number in "other income" above, please give more details on where this income comes from, also if it is a job that requires your vehicle, please list how much gas you are using per week.
{"type":"textarea","name":"__generic83","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Details on \"other income\" if none type n/a","height":80,"placeholder":""}
If your income doesn't meet our housing requirements, are you willing/able to bring in more income either by obtaining a new job or getting a second job?
{"type":"radio","name":"__generic87","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}
If you don't qualify for our program right now based on where you are living, working or kids are enrolled at for school, then we will consider you for our program AFTER you obtain employment in our service area. Would you be willing to move your job to our service area? (If you answer yes below, then this will be your first goal to get employment in our service area)
{"type":"radio","name":"__generic88","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please make a selection for this item.","options":"Yes\nNo\nN/A- I currently live, work or kids are enrolled in school in your service area."}
How did you hear about Journey to Housing:
{"type":"checkbox","name":"__generic92","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please check at least one item.","options":"Internet Search\nLocal St. Vincent DePaul Conference \nSocial Worker \n211\nOther"}
Assessment of Consent:
Journey to Housing will conduct a criminal background check to proceed with the housing process. Expungements are accepted. Do you consent?
{"type":"radio","name":"__generic107","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}
Journey to Housing will conduct a credit report assessment to proceed with the housing process. Do you Consent?
{"type":"radio","name":"__generic108","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}
Journey to Housing will conduct drug testing to proceed with the housing process, if needed. Do you consent?
{"type":"radio","name":"__generic109","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes\nNo"}
Next Steps:
1. I will reach out to you via e-mail in 1-3 business days. Please check your spam. Will you check your spam?
{"type":"radio","name":"__generic111","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please make a selection for this item.","options":"Yes"}
CERTIFICATION
I certify that the answers to the above questions are true and complete to the best of my knowledge and belief, and I understand that a knowingly false or incomplete answer may be grounds to disqualify me from consideration for, or participation in, the Journey to Housing Program.
Please use your finger to sign if on a smart phone/ tablet. If on a computer you can use a mouse or the touchpad.
{"type":"signature","name":"__signature","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please type your name as a e-signature.","height":50}
