REQUEST FOR HOMELESS FAMILY SERVICES

If you are seeking services or if you know of a homeless family or a family on the brink of homelessness, refer them here or call us at 470-560-0854
To request ESFSG services, complete the below application form and the intake form at this link. Send the form to referral@exousiahouseofgeorgia.org.
What Services do you Seek?
What Service are you Requesting?
ARE YOU A DOMESTIC VIOLENCE VICTIM?
Domestic violence victims receive referrals that require strict confidentiality.
HEAD OF FAMILY (NAME)
Enter the circumstances surrounding your/their homelessness
Name of Child 2
Include your county and state
Is this a military veteran family?
Are you employed??
FOR ESFSG SUPPORT AGENTS ONLY
EMPLOYMENT
Radio
Please select all that apply
Mail your intake form to this email address
Now, please complete the INTAKE FORM.
One of our Support Agents will contact you within 48 hours. If this is a medical emergency, please dial 9-1-1.
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216 Atlanta Rd Suite F , PMB 1027 Cumming GA 30040 US
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Exousia House of Georgia is a 501(c)(3) nonprofit organization, EIN 88-4261879. Donations are tax-deductible. ©2024 . Copyright © All rights reserved.