SUNSHINE COAST COMMUNITY SERVICES
Keeping People Housed Pre-Assessment Form

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Step 1 of 3

PART ONE: YOUR INFORMATION

You must have at least one piece of Photo ID
Low-Income Cut Off Table

NAME AND CONTACT INFORMATION

YOUR ADDRESS & HOUSEHOLD DETAILS

Number of Adults in the Household over the age of 18 years old
Number of Children/Dependents in the Household
Total Number of People in the Household
Ie. parent, child, partner, spouse, roommate. Max 50 words

PERSONAL INFORMATION

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