Resident Application

Please fill out the form below to apply for residency at Lydia’s House of Hope. Our process to be admitted begins with your application below.  Once we receive the application, a caseworker will contact you within 48 hours to review your information and help you move forward in the application process. Please be as honest and as accurate as possible. Background checks will be conducted for anyone selected to enter Lydia’s House of Hope.

Lydias House of Hope Resident Application

Lydias House of Hope Resident Application

Personal Information

Name
Name
First
Last
Current Address
Current Address
City
State/Province
Zip/Postal
Are you a US Citizen?
is it OK to call?
Is it OK to leave a message?
Are you currently in a romantic relationship?
Please Note: We ask that no romantic relationships be pursued during your time in the program as it is a time for self-improvement and independence.
Are you currently pregnant?
Have you ever lived in a shelter, hotel, or transitional housing?

If it is easier to print the application and mail/fax it, you can download it at the link below. You can mail it to 21 Grand St., Somersworth, NH 03878 or fax it to (833)801.1116