Housing Survey

* Indicates required field

Name of individual looking for housing *

First

Last

Name of Parent/Guardian(s) *

Email *

Age of individual looking for housing *

Timeline for when you wish to be in housing *

Ideal Housing situation (single apartment, bedroom within a shared house, etc.) *

Ideal Supports (friendly neighbours only, live-in mentor, daily check-in mentor, support for feeding and dressing, etc) *

Ideal location of housing (Downtown Barrie, SW Barrie, Orillia, etc.) *

Other Comments *

Submit