Formerly Incarcerated Survey
This form is used for collecting data from formerly incarcerated or justice involved individuals who have been told that they could not reside with family, a friend or a loved one because their loved one lives in low income, subsidized, public or section 8 housing.  

The data will be used to create a report that will document how the current housing policies discriminate and target a particular population as well as adding to the increasing homeless problem in the Commonwealth of Massachusetts.
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Email *
First Name *
Last Name *
Facility Name of halfway house
Street Address
City
State
Zip Code
Phone Number
Gender *
Race *
Age *
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