Intake form

Help us serve you better

Name *

Email address *

What type of assistance are you seeking?

Please select at least one option.

Rental assistance

Homeownership support

Housing counseling

Community development

Affordable housing advocacy

What is your current housing situation?

How many people are in your household?

What is your total household income?

What is your preferred method of contact?

Have you previously received assistance from housing help plus?

What is the best time to contact you?

Please provide your current address.

Additional questions or comments

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Housing Help Plus