Community Agency Referral

C&G Independent Living & Transitional Housing welcomes referrals from community agencies that are assisting individuals in need of safe, stable housing.

  • Safe. Supportive. Affordable.

Housing Costs Are Rising

Rent prices have increased dramatically in recent years

Affordable housing remains limited across many communities

Thousands of individuals need safe, stable housing options

Utilities and furnishing costs continue to increase

C&G provides a practical, affordable housing solution.

Partner With Us

We accept referrals from organizations including:

  • Emergency shelters
  • Community Services Boards (CSBs)
  • Hospitals and behavioral health providers
  • Social workers and case managers
  • Veteran service organizations
  • Re-entry and probation programs
  • Domestic violence agencies
  • Faith-based organizations
  • Government assistance programs
  • Nonprofit organizations
  • Other approved community partners

Community agency referrals help us better understand an applicant’s current circumstances and coordinate services when appropriate.

Please complete the referral form below with as much information as possible. A member of our team will review the referral and contact both the referring agency and the applicant if additional information is needed.

Please note: Submitting a referral does not guarantee acceptance into the program. All referrals are reviewed according to our eligibility requirements and current program availability.

Community Agency Referral Form

Referring Agency Information

Agency Name

Agency Address

City

State / Province

Zip Code

Referral Contact

Contact Name

Job Title

Phone

Email address

Applicant Information

Full Name

Date of Birth

Phone

Email address

Current Address

Emergency Contact

Name

Relationship

Name

Current Living Situation

Reason for Referral

Income Information

Does the participant receive any monthly income?

Monthly Income Amount

Does the participant receive any monthly income?

Independent Living Assessment

Has the applicant demonstrated the ability to live independently?

Additional Information