Email Application Template

This application option is currently closed and is displayed for informational purposes only.

If you prefer to apply by email, please copy and paste the template below and send your information to:

kaia.hastings@brokenchainliving.com

Subject Line:

Housing Application – [Your Full Name]

Please include the following information in your email:

Full Name:

Phone Number:

Email Address:

Age:

Are you a Senior (60+), Veteran, or Senior Returning from Incarceration?:

Current Living Situation:

Income/Benefits (SSI, SSDI, Pension, VA, Disability, Employment, etc.):

Preferred Move-In Timeframe:

Brief Description of Your Housing Needs:

Response Time

A team member will contact you within 1–2 business days to review your information and discuss next steps.

Submission of an email application does not guarantee placement and is subject to eligibility review and program availability.