Women’s Housing Application Form

We’re glad you’re taking this step. Please share your name and a way to contact you — someone from our team will follow up based on availability.

Note: If your situation changes or you have questions, please contact us directly at (250) 382-0283 or email info@anawimsociety.ca.

If you are in immediate danger or need urgent housing, please contact the Vancouver Island Crisis Line at 1-888-494-3888 or visit our Services page for more resources.

Legal Name

First Name

Last Name

Preferred Name (If different from Legal Name)

First Name

Last Name

Preferred Pronouns

Phone

(###)

###

####

Preferred Method of Contact (Choose one or both)

Phone

Either

Are you currently 30 days sober or more?

Note: Anawim Companion Society offers sober housing. We ask that applicants have a minimum of 30 days of sobriety.

Are you 19 years of age or older?

What is your current housing situation?

Tell us a little about where you’re living now and any challenges you’re experiencing.

Our homes are shared spaces with other residents. Are you comfortable with communal living and able to navigate shared responsibilities and respectful interactions with others?

The cost of living at Anawim is $700/month ($500 for rent + $200 for program fees). How do you plan to cover this monthly cost?

Eligibility Acknowledgement

Anawim houses are for single adults only. Unfortunately, we are not able to accommodate children or family-based housing needs. If you require housing that includes family or children, please see our resources page for information about other services. www.anawimsociety.ca/services

I understand that Anawim housing is only for single adults.

Optional Information

This section is not required, but helps us better understand how to support you

Do you have any health conditions, mental health needs, disabilities, or support requirements you’d like us to be aware of to better support you in your recovery and daily living?

This could include medical conditions, diagnoses, mobility needs, mental health supports, or anything else you feel is important. Sharing is optional and only used to help us support you.

Are there any supports you feel would help you maintain your sobriety while living in a shared home?

Examples: counselling, peer support, structure, quiet space, cultural connection, etc.

What are some of your goals while living at Anawim?

This could include recovery goals, education, employment, life skills, or personal growth.

Is there anything else you’d like us to know about you or your recovery journey?