Information Request form
A place of hope and change for women.
women experiencing homelessness, women, homeless, homelessness, shelter, safety, stability, women's shelter, day center, Sophia's Place, Helen's Place, Bellevue, Kirkland, homeless in King County, housing
2878
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Information Request Form

Please fill the form for our Extended-Stay Shelter

  1. Our Intake Specialist will contact you in a timely manner.
  2. You will be placed on a wait list.
  3. We will contact you when a bed is available.

For more details, click here

    Contact Information

    Name (required)

    Date of Birth (required)

    Best phone number to contact you

    Email

    Demographics

    Homeless?
    yesno

    City you became homeless from

    Current City of Residence

    Emergency Shelter guest?
    yesno

    Day Center guest?
    yesno

    By submitting this form you are agreeing to a background check.