Application to Joseph Outreach Community Services

If you are a veteran or individual interested in applying for housing at Joseph Outreach Community Services in Bethlehem OR are applying on behalf of a veteran or individual, please complete the brief questionnaire below and our team will contact you soon.

All information shared is confidential.

Name

First Name

Last Name

Phone

(###)

###

####

Email

Reason for requesting residence?

Where do you live? (If you don't have an address, please write "N/A").

Were you referred by someone or by an organization? If yes, please indicate who is referring you.

In which branch of the military did you serve?

How long did you serve?