EMERGENCY Housing Exit Form

Emergency Housing Exit Form

Full Name

Exit Date

Voluntary Exit

Keys Returned

Moving Out Of

Others*

Room #/ Unit #/ Big House/ Small House

How did your emergency stay at PT assist you in your situation?

Are you moving our transitional housing or to another form of housing?

If another form, please check which type:

Please explain Other

Upon exiting the program, you are required to remove all personal belongings. If you leave any belongings behind, we will dispose of them after 18 days. If you take any property belonging to Project T.O.U.C.H when you exit the program, you will be prosecuted. NO DEPOSIT will be returned if KEYS are not returned. (If you have certain needs upon your exit, be sure to call Admin., if we are able to assist you, we will attempt to do so.)

By signing below, I agree and understand regarding my possessions & and the property belongs to Project Touch.

Signature

Clear

Date

Print Name

Phone *

Administration Signature

Clear

Case Manager Advised By:

Date

Go Back