Apply for our Waitlist

Availability of beds in: women's rooms or men's rooms (rooms are gender-specific)
Date and time your completed application is received
Program eligibility based on individual needs assessment
Current resident census and room availability

We encourage you to apply even if rooms are currently full. We will contact you as soon as a space becomes available.

Fields marked with * are required

Are you referring yourself?

Yes

If no, relationship to the person you are referring

If you are part of a community based organization, please provide your name, title, phone and email info

Legal Name

Preferred Name if different

Gender Identity

Phone Number

Email Address

If we can’t reach you, who else should we contact?

What is your current living situation?

What is your target date to move?

Are you receiving support from an organization in the community?

What is your current relationship with: Alcohol, Nicotine, Marijuana, Other Drugs

For each substance-Past or Current use? If yes, how often/much? If past use, How long clean /sober?

Describe your experience with communal living- both the good parts and the challenges

Serenity Homes is a clean and sober shared residential environment. How will participating in our program help you?

What challenges do you think you may encounter in our program? How can we best support you?

Are you committed to engage in housing navigation and recovery activities while participating in this program?