YWCA Jamestown Empower Her Housing

Transitional Housing Program Referral Form
Basic Admission Criteria

Single women and women with up to 2 children.
Applicant Must be over 18
Male children must be under 12 years of age
Must be homeless or at-risk of homelessness upon entry

Submit the completed form to: Jacqueline Cook, legacyhouse@ywcajamestown.com. For more information, call 716-488-2237 x 247