Residency Application

All questions must be answered otherwise the application will be denied.

Application is also available as a downloadable PDF here.

Para la aplicación en español, envíe un correo electrónico a brandy@clarehouselancaster.org

If you experience technical issues with completing the form, please email Dawn (Dawn@clarehouselancaster.org) or call (717) 291-8967.

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Agencies you and/or your children are working with:

Leave blank if you have worked with no agencies.

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*By clicking submit below, I give Clare House, Inc. permission to verify information given in this application to determine my eligibility for this program. I affirm that all information is true and understand that any false or incomplete information will disqualify my application for residency.

Thanks for submitting!

Children

Leave blank if you have no children.

Income