Housing Client Form

The following form is to help White-Wolf Ministries do it's best to help place you in a living space that you can afford. All information is confidential. Please be open, honest, and accurate in your information provided. White-Wolf Ministries will not hold any information given against you. We are here in service, not to fix you.

Please know that White-Wolf Ministries will help you with your search for housing.
Do your own room, and apartment hunting, and check in once a week with your case manager!

Housing Client Information

Housing Client Information

This is used for White-Wolf Ministries to assess your Housing Goals.

Please complete all fields marked with an *

Housing Situation *
I am *
Special Needs *
Status *
Sexuality (This is to find appropriate funding for you)
Children *
If you have children will they be living with you?
Pets (Select All That Apply)
Source of Income (Check All That Apply) *
College or University Student?
Criminal Record *
Have you ever been arrested for domestic violence? *
Are you suicidal? *
Are you in treatment for mental health Issues? *
Tobacco Smoker?
Alcohol Use *
Drug Use *
Type of Housing you would like (check all that apply) *
I am willing to live with:
I authorize White-Wolf Ministries to contact agencies on my behalf for housing *