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About Us
Need Housing?
Get Involved
News
Contact Us
- HABcore Staff
- FAQs

Pre-Application for Congregate Home Residency

Dial 211 if you need emergency housing.

Please fill out the Pre-Application Form for Boarding Home Residency below. Questions with an asterisk * by them are required.

ATTENTION:

THE PRE APPLICATION FORM BELOW IS ONLY FOR SINGLE ADULTS over 21 years old FOR OUR WAITLIST

If you are under 21 years old, contact,

Ocean’s Harbor House808 Conifer St., Toms River, NJhttps://www.oceansharborhouse.org/orCovenant House520 Prospect Ave. Asbury Park, NJ

https://www.covenanthouse.org

FOR PEOPLE SEEKING APARTMENTS ONLY AND NOT OUR CONGREGATE HOME PROGRAM –

PLEASE CALL THE FOLLOWING NUMBERS

Monmouth County
If you are homeless and seeking housing assistance in Monmouth County, please call the Monmouth County Centralized Intake System at (732) 431-6000 x 4613 or visit visit their website here

Monmouth County Adult Homeless Shelter for Individuals Only – CLICK HERE: Monmouth County Adult Homeless Shelter Information

Ocean County
If you are homeless and seeking housing assistance in Ocean County, please contact Affordable Housing Alliance at 732-341-2272 or go to www.housingall.org

Please fill out the form below. All required fields have an asterisk *

Personal Information
Today's Date*
Month
Day
Year
Your Name*
First Last
Your Phone*
Your Email
I identify my gender as:*
Your answer will help us to place you in the best living environment.
- Male
- Female
- Genderqueer/Non-binary
- Other
If you answered "other," please specify
What is your current age?
Name of Emergency Contact Person*
First Last
Emergency Contact Phone Number*
Are you a Veteran?*
- Yes
- No
In what branch did you serve?
- Army
- Navy
- Air Force
- Marines
- Coast Guard
Do you have a DD-214 form, the Certificate of Release or Discharge from Active Duty?
If you are a veteran, you need to have this form's information for us to help you. You can go to https://www.archives.gov/veterans/military-service-records to request the DD-214.
- Yes
- No
Household Information
Are you an:*
- Individual
- Family (more than 1 person) IF SO, STOP HERE. BOARDING HOMES ARE ONLY FOR SINGLE ADULTS
What County are you currently staying in?*
- Monmouth County
- Ocean County
What is your current housing situation?
Do you have a disabling condition that is permanent or expected to be long-continuing?*
Do you have: 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 OR 3. Acquired Immunodeficiency Syndrome (AIDS) Are you able to manage activities of daily living? Can you bathe and eat independently?
- Yes
- No
- I don't know
If you answered "Yes," please explain:
Do you have Medicaid?*
- Yes
- No
- I don't know
How much is your monthly income? Please list all sources and amounts.*
Who referred you to HABcore?*
- Friend or Family
- Church
- Agency
Please include name, job title, and phone number*
Have you ever been arrested?
Please note that we complete background checks for all potential residents.
- Yes
- No
If you answered "Yes," please explain
Is there anything else you feel is important for HABcore to know?
Date

HABcore delivers affordable housing and supportive services to vulnerable families, veterans and individuals with special needs. We help those experiencing homelessness or housing insecurity move from crisis to stability, fostering independence and a better quality of life.

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