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Get in touch with us at refugehousekc.org

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Rebuilding , Reshaping , Rehousing
our Community.

Registration for Refuge House LLC

Date

First name

Last name

Email

Phone

Birthday

Are you currently Homeless ?

Do you receive Government Assistance ? If so, How Much?

How soon are you needing housing?

Are you okay with Sharing a room with someone else?

Are you able to follow rules of the house ?

How soon do you need to move in?

How many beds will you need?

This form is to register with Refuge House so that we keep accurate count of registrations from each individual. We are currently operating off of a waitlist. When we reach your name we will reach out with intake and application forms to continue onboarding and possible move ins. Thank you for registering with refuge house LLC.

© 2023 by Refuge House.

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