The Sophia Way | Sophia’s Place Pre-Screen
Assisting women from homelessness to stable independent living.
homeless women, homeless, homelessness, shelter, safety, stability, shelter, women's shelter, Bellevue, homeless in King County
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Sophia’s Place Pre-Screen

Sophia's Place - door a

Name (required)

Date (required)

Phone Number (required)

Date of Birth (required)

Homeless?
yesno

Minor Children?
yesno

Custody?
yesno

City where you first became homeless

Current City

Former Sophia's Place resident?
yesno

If yes, how many times?
123 or more

Current DV situation?
yesno

Income

Have you ever been arrested?
yesno

If yes, what was the charge?

Notes: I consent for The Sophia Way to run a criminal history background check on me to determine my eligibility for the program.