Transitional Housing Program FAQ s

Transcription

1 Breaking the cycle of poverty and homelessness and building self sufficient households Transitional Housing Program FAQ s Thank you for your interest in HOTEL INC s Transitional Housing Program. Before applying, please read the following information carefully: What is HOTEL INC Transitional Housing? HOTEL INC offers a transitional housing program designed to provide a free apartment/house for 90 days so residents can save money, pay off bills, learn new life-skills, regain confidence, then move into a permanent residence. What are the houses/apartments like, and where are they located? HOTEL INC rents one, three-bedroom house in Bowling Green within walking distance of the GO Bus. The house has a living room, kitchen/breakfast area, one bath, and a washer and dryer. Each apartment/house is also furnished, including dishes, pots/pans, linens, etc. Future apartments/ houses may be added. What are the Transitional Housing resident requirements? All adult residents must work full-time or secure full-time employment within thirty days of submitting the following application. At minimum, a part-time job must be held when the application is submitted. Adult residents must agree to attend weekly budgeting and life-skills sessions with HOTEL INC counselors. These meetings vary and will be scheduled around the resident s work hours. Each resident is expected to work hard at saving money and securing a permanent residence by the end of the three-month program. Each resident will help with the apartment/house cleaning and maintenance. How do I apply? To be considered for the Transitional Housing Program, the following application must be completed and either dropped-off, mailed, or faxed to HOTEL INC. It is the applicant s responsibility to contact HOTEL INC should your contact info need to be updated. Once an apartment/house is available, the Transitional Housing committee will invite you to an interview to discuss the program as well as your needs, concerns, and goals. Within two weeks of the interview, you will be contacted about the committee s decision. MAILING ADDRESS PO Box 1688, Bowling Green, KY Phone: Fax: PHYSICAL ADDRESS 1005 Boatlanding Rd., Bowling Green, KY 42101

2 2 Transitional Housing: Application For Office Use Only Date of Application: Follow Up Calls: 1. Primary Applicant Name 2. Co-Applicant Name 3. Phone Number 4. Where are you living right now? (circle one) House/Apt Friends Relatives Shelter Hotel Street Car Other 5. Address 6. How long have you been there? 7. Have you ever applied to or lived in HOTEL INC Transitional Housing? 8. Have you been asked to leave your current living situation? 9. Were you referred to HOTEL INC Transitional Housing? If so, who referred you? 2

3 3 10. In the chart below, list all who would be living in the transitional apartment/house (including yourself): Name Relationship Date of Birth Soc. Sec. # Grade/School Name of Child s Father Type of Custody 11. Are you or any of the applicants listed above pregnant? Due Date: 12. Do you have a car? Yes No Year Model 13. Do you have car insurance? Yes No 14. Driver s License Number State Expiration 15. Tag # Current? Yes No State Current Inspection? Yes No 16. Please list your references for this program or emergency contact(s): Name Relationship Address Phone Number 3

4 4 Personal History: 1. Name: Age: S.S.# 2. Date of Birth: Location of Birth: 3. Married Single Divorced Separated Widowed 4. Previous Marriages? Yes No 5. Race (circle): Caucasian African-American Native American Other 6. Education Level (circle one): some college college degree 7. School Grade Average (circle one): A B C D F 8. High School/GED 9. College (School Name & Year Graduated) (School Name & Year Graduated) 10. Job History (Last 5 Years): Year Company Name Pay Rate Duties Reason for Leaving 11. Family History: Parent s Names Address (City, State) Phone Numbers 4

5 5 Sibling s Names Address (City, State) Phone Numbers 12. Do you smoke? Yes No How much per day? 13. Do you use drugs or alcohol? Yes No 14. Have you ever been in drug or alcohol rehabilitation? Yes No If yes, when? Name of abused substance? Rehab facility name? Are you an AA participant? Yes No Are you an NA participant? Yes No 15. Have you ever been arrested (DWI, bad checks, assault, etc.)? Yes No What for? Did you receive a fine/sentence? Yes No 16. Have you been a battered person? Yes No When? 17. Have you served any time in jail? Yes No How long? 18. Do you have any pending tickets (speeding, parking, etc.)? Yes No What for? When is your court date? 5

6 6 19. Are you on parole or probation at present? Yes No How long? Parole Officer: Phone Number #: 20. Is there a warrant out for your arrest at present? Yes No Reason: 21. Have you ever been evicted? Yes No If yes, when and why? 22. Please explain briefly the reasons for your current situation: 23. Tell us why you wish to participate in HOTEL INC s Transitional Housing program: 6

7 7 Financial Assessment: 1. List any income currently received from a Job, Food Stamps, KTAP, TANF, SSI, etc: *If child support is owed to you, list the monthly/total amount owed* Income Source Monthly Amount 3. Current Case Worker s Name: Phone Number: 4. Name of Social Services Office: 5. Do you or anyone living with you receive medical or counseling services? Name Medical Condition Medication 7

8 8 6. List all bills or debt in the list below: Item Amount Due Monthly Payment Past Rent Cable Electric Gas Telephone Water Storage Past Due? Y/N Student Loans Payday Loans Bankruptcy Credit Cards Bad Checks Title Loans Medical Child Support Childcare Car Payment Car Insurance Tickets/Fines Repossessions Clubs Pawn Shop Cell/Pager Other Total Bills/ Debt

9 9 HOTEL INC Transitional Housing Program Rules of Residence The following rules of conduct shall be in effect while a guest individual/family resides in any HOTEL INC apartment/house. Violation of any rule will, at the sole discretion of the Board or Staff, be cause for immediate dismissal from the building and program. 1. No illegal activity of any kind will be permitted. 2. Use or possession of alcohol, pornography, prostitution, or illegal drugs is prohibited. 3. Curfew is 11:00 pm. This can only be waived for work schedules. Guests must be out of the house by 10:00 pm. Quiet hours are : 10:00pm through 7:00 am. 4. No overnight guests are allowed unless written permission is obtained through a staff member. 5. Children under the age of 13 must be attended by an approved adult at all times. 6. Children must be enrolled in the school district nearest HOTEL INC or in the district your family originates from. They must attend school every day that is required. 7. No fighting of any kind will be tolerated.; 8. No pets of any kind will be allowed. 9. Smoking is NOT permitted inside the apartments, houses, or offices. 10. Guest families must keep apartments/houses clean and neat. 11. All adults living in Transitional Housing are expected to work at least hours per week. 12. All adults must attend scheduled meetings and appointments. A $100 deposit will be taken at time of move-in or at time of first paycheck, to cover costs of cleaning, damage, or non-completion of program. I have read and understand that if I violate any one of these rules I may be dismissed from the HOTEL INC program. I agree to hold HOTEL INC Transitional Housing and/or any other parties associated with this program in any way whatsoever, singly, or collectively, from any blame or liability for injury, misadventure, harm, loss, inconvenience, or damage suffered or sustained as a result of participation in this program or in activities associated therewith. I give permission for information to be released about me and my children, to HOTEL INC Transitional Housing. If accepted into the HOTEL INC program, this signed application will serve as a binding lease for a period up to 90 days. Applicant Signature Date Co-Applicant Signature Date 9