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Request for Housing Services

If you are an LGBT young adult (18-25+) facing or experiencing homelessness, please fill out this form to the best of your ability. A staff member of Lucie's Place will contact you within a few business days (we are closed on the weekends and not able to consider emergency requests on those days). Please provide as much information as possible about you, your situation and what sort of help you need. 

Please check each box, showing that you understand and agree: