Housing Application - Vision House

About Vision House
Vision House provides transitional housing with supportive services in Renton and Shoreline, Washington to help families experiencing homelessness move from crisis, to stability and permanent housing. We also have a Diversion Center in Renton to assist families with their immediate needs to help keep them from enterig the shelter system.
Application for Assistance
Please complete this application as thoroughly as possible. Questions marked with * are required. This application WILL NOT SAVE YOUR ANSWERS IF YOU LEAVE THIS PAGE WITHOUT SUBMITTING THIS FORM.
Applicant's Legal Name*
First Last
Nickname or Other Name Used
Age*
Date of Birth*
Date Format: MM slash DD slash YYYY
How do you identify (gender)?*
Phone*
Email
What is the best time of day and way to contact you (email or phone call)?*
Where are you currently sleeping (Vision House serves families in all of these situations)*
- Living with friends/family
- In a car/tent
- Shelter
- Transitional Housing
If you're living in a shelter or transitional housing, what is the name?
In what city are you currently sleeping/living?*
What form of identification do you have?*
- Driver's License
- State ID Card
- I'm trying to obtain identification
Which of these items do you have?*
- Social Security Number
- Green Card
- Work Visa
- Other (will explain during first phone call)
Do you currently have a lease?*
- Yes
- No
Are you in immediate risk of eviction?*
- Yes
- No
Children in Your Custody
List each child on a separate line. To add another row, click on the + at the end of the row.
Child's First Name Child's Last Name Child's Age Child's Date of Birth (month/day/year) Child's Identity (Gender)
Comments/Other Information You Would Like to Share?
CAPTCHA

Child's First Name	Child's Last Name	Child's Age	Child's Date of Birth (month/day/year)	Child's Identity (Gender)

About Vision House

Application for Assistance

… until every child has a home.