Screening Form

Family Promise of Gwinnett County Initial Screening Form

In efforts to serve your family better we will need some basic information to determine your familys' eligibility for the Family Promise Network.
Please complete this form and click submit below.

Name

Number of adults in your household

Number of children in household

Phone number to reach you

Where are you currently living?

Why are you homeless (Briefly explain)?

How long have you been in Gwinnett County?

How long have you been homeless in Gwinnett County?

Is anyone in the family currently employed?

Do you have your own transportation?

You will be contacted within 24 to 48 hours to let you know if you are eligible for the Family Promise Network.

In order to eliminate spam bots, please enter the code seen below