Brantford-Brant Stay Housed Initiative Intake Form

Please note that clients must consent to sharing their personal information and be motivated to participate in this program. Client consent form must be attached to this application.

Personal information in this form is collected under the authority of section 10(1) of the Municipal Act, 2001, as amended and will be used solely to contact persons making application for the Stay Housed initiative with the City of Brantford. Questions about this collection should be directed to the Housing and Homelessness Department at 519-759-4150.