Are you in need of shelter?

Please complete the Shelter Application below.

We receive a high volume of applicants and have very few openings in our shelter.

If you have any questions, please call our office: (978) 922-0787

 

EMERGENCY SHELTER APPLICATION

  • LEAD APPLICANT INFORMATION (Head of Household)

    Please complete entirely. Due to the high volume of applications and our shelter's size, not every applicant will receive a call-back.
  • Last place you've lived for longer than 6 months and/or where you last paid rent.
  • i.e. Male, Female, Non-Binary, Other, N/A...
  • Please select all that apply.
  • Please include your income and any income received from children.
  • HOUSING SITUATION

    Please tell us more about your current housing situation and needs.
  • SECOND ADULT INFORMATION

    Please list information of second adult also seeking assistance...
  • i.e. Male, Female, Non-Binary, Transgender, N/A...
  • Please select all that apply.
  • CHILDREN

    Please provide information regarding your children...
  • Initials, Age, Gender Identity (i.e. Male, Female, Non-Binary...)
  • OTHER HOUSEHOLD INFORMATION

    Please provide some additional information to help us provide the best assistance.
  • Please list the total amount of your household's income from all sources.
  • Please note that our shelter is a low-barrier program. Having a criminal history will not prevent admission to the program. However, failure to answer this question and omission of details could lead to future discharge from the program.
  • How many months of sobriety? (If less than one month, just put "1")
  • i.e. "One dog, two cats."
  •