To submit this referral form to Threshold Housing Society staff for review, please fill in as much information as possible, then press the send button at the bottom of the page.

  • How would you like us to refer to you? For example, "he/him/his", "she/her/hers", "they/them/their", etc.
  • We will not contact them before speaking with you.
  • We will not contact them before speaking with you.
  • We will not contact them before speaking with you.
  • We will not contact them before speaking with you.
  • We will not contact them before speaking with you.
  • We will not contact them before speaking with you.
  • e.g.: probation, substance abuse, mental health diagnosis, physical challenges, etc.
  • Please provide 2-3 references who can speak to your character and readiness to enter the program. The references would preferably be: a) a professional counsellor, social worker, outreach worker, school counsellor, teacher, etc., b) a family reference; c) an employer or co-worker Please tell us HOW you know this person and for how long.
  • Please provide 2-3 references who can speak to your character and readiness to enter the program. The references would preferably be: a) a professional counsellor, social worker, outreach worker, school counsellor, teacher, etc., b) a family reference; c) an employer or co-worker Please tell us HOW you know this person and for how long.
  • Please provide 2-3 references who can speak to your character and readiness to enter the program. The references would preferably be: a) a professional counsellor, social worker, outreach worker, school counsellor, teacher, etc., b) a family reference; c) an employer or co-worker
  • Please provide 2-3 references who can speak to your character and readiness to enter the program. The references would preferably be: a) a professional counsellor, social worker, outreach worker, school counsellor, teacher, etc., b) a family reference; c) an employer or co-worker
  • Please provide 2-3 references who can speak to your character and readiness to enter the program. The references would preferably be: a) a professional counsellor, social worker, outreach worker, school counsellor, teacher, etc., b) a family reference; c) an employer or co-worker
  • Please provide 2-3 references who can speak to your character and readiness to enter the program. The references would preferably be: a) a professional counsellor, social worker, outreach worker, school counsellor, teacher, etc., b) a family reference; c) an employer or co-worker
  • NOTE: The primary mission of the Threshold Housing Society is to provide transitional housing for youth. If a referred youth has mental health or physical challenges we can only house a youth with the appropriate external support in place prior to residency. Such supports might include a social worker, a drug and alcohol counsellor, assistance with an eating disorder or self-harm, CLBC assistance, a public health nurse, a psychiatrist, etc.
  • Please provide any other information that may help us get to know you better
  • This field is for validation purposes and should be left unchanged.

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