Staff & Board of Trustees
Apply for Housing
Siemens Builds HABcore a Shed
Home Sweet Home 2015
Home Sweet Home 2016
HABcore Board, Staff and Friends
HABcore Picnics and BBQs
Pre-Admission Questions for Waitlist
Please fill out this form and we will contact you if we need more information.
Date of Birth
Email (If Applicable)
Are you a Veteran?
Which program are you applying for?
Boarding Home (For single adults over 18 years, 24 hour support staff on site)
Apartment Program (For individuals and families)
If selected, do you have a preference on location?
Describe your current housing arrangement:
Are you chronically homeless? If yes, please describe your housing history. Chronically homeless is defined as “an unaccompanied homeless individual with a disabling condition who has either been continuously homeless for a year or more OR has had at least four (4) episodes of homelessness in the past three (3) years totaling 12 months. HUD regulations define "homelessness" as follows: 1. Places not meant for human habitation, such as cars, parks, sidewalks, and abandoned buildings; 2. An emergency shelter including Emergency Housing Assistance from the Division of Social Services; OR 3. Safe Haven - a form of supportive housing that serves hard-to-reach homeless persons with severe mental illness who are on the street and have been unable or unwilling to participate in housing or supportive services. Safe Havens serve as a refuge for people who are homeless and have a serious mental illness. Examples of settings where someone would NOT be considered literally homeless would be: Couch surfing, transitional housing, boarding homes, a valid rental pending eviction.
Are you chronically homeless?
If so, what date did your chronic homelessness begin?
Do you have a disabling condition that is permanent or expected to be long-continuing?
IF YES OR UNKNOWN, PLEASE EXPLAIN. For our purposes, disabling conditions must fall under one of the following categories: 1. A physical, mental, or emotional impairment, including an impairment caused by alcohol or drug abuse, post-traumatic stress disorder, or brain injury; OR 2. A developmental disability, as defined in section 102 of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15002); OR 3. The disease of acquired immunodeficiency syndrome or any condition arising from the etiologic agency for acquired immunodeficiency syndrome
If YES to above, please explain:
Please list all family members who will be living with you including name, date of birth, gender, and relationship to applicant:
How much is your monthly income? Please list all sources and amounts:
Who referred you to HABcore? (If an agency referred you, please include name, job title, and phone number of referral source)
Have you ever been arrested?
Please note that we complete background checks for all potential residents.
If YES to the above, please explain:
Is there any additional information you feel is important for HABcore to know?
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Red Bank, NJ 07701