URM Intake Application

All guest must have a proof of ID and pass Megan’s law clearance

MM slash DD slash YYYY
Drop files here or
Accepted file types: pdf, jpg, jpeg, doc, Max. file size: 512 MB, Max. files: 2.
    What is your current living situation?(Required)

    MM slash DD slash YYYY
    Are you in need of immediate shelter?(Required)

    Would you be interested in enrolling in one of our offered programs?(Required)
    Where were you staying prior to coming to this mission?(Required)

    Union Rescue Mission History/ Homelessness History:

    Have you previously received shelter service at URM?(Required)
    Are you currently on the waitlist for Section 8/ Public housing(Required)
    What services have you used in the past?(Required)
    Do you agree to quarantine for 5 days upon arrival and be tested for covid-19?(Required)