Family & Youth Homeless Prevention Services (FYHPS) Pre- Application
The Family & Youth Homeless Prevention Services (FYHPS) is a program where we offer case management & culturally specific support with our housing outreach manager, along with eviction prevention services like rent & deposit assistance to BIPOC families (Black, Indigenous or Person of Color).

Our programs qualifications are:
1.Target Population: BIPOC family who's either pregnant, has children or in process of reunification.
2. Unhoused or on the verge of unhoused.
3. Is considered low-income. 
4. Located in the Minnesota/St. Louis County area
5. Agreeing to in-home visits
6. Agree to Receive Supportive Services 
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Full Name  *
Today's Date  *
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I am able to agree to the following program qualifications:
1. Target population: BIPOC family who's either pregnant, has children or in process of reunification.
2.Unhoused or on the verge of unhoused.
3. Is considered low-income. 
4. Located in the Minnesota/St. Louis County area
5. Agreeing to in-home visits
6. Agree to Receive Supportive Services 
 *
Preferred Pronouns  *
Phone Number *
Email *
Secondary Contact Phone Number/Email
What services are you requesting? *
Dollar amount of Assistance Needed *
Do you receive a Section 8 voucher?
Clear selection
If requesting one-time housing payment or deposit assistance, how much are you requesting in total?
D.O.B  *
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What is your race?  *
Are you pregnant? If yes, please select your current trimester.... *
Please list your children's names and their ages.  *
Please list additional household members and their ages. *
Do you currently have an open case with CPS?  *
Are you unhoused, couch hopping or on the verge of homelessness?
Clear selection
Please explain your current living situation. thank you. *
What is your monthly gross income (before any deductions)? What are your income sources? *
Are you currently, or have you dealt with any of the following? *
Required
Referring Agency and contact information *
*For Referring Agency Only: Do you have an ROI signed to talk further with the Housing Outreach Manager or Executive Director at Divine Konnections Inc.?  *
Is there any additional information that we should know or consider? *
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