{"id":26,"date":"2026-02-19T10:23:29","date_gmt":"2026-02-19T10:23:29","guid":{"rendered":"https:\/\/projects.techhivetechnologies.com\/openarms\/?page_id=26"},"modified":"2026-04-14T21:28:12","modified_gmt":"2026-04-14T21:28:12","slug":"apply-now","status":"publish","type":"page","link":"https:\/\/projects.techhivetechnologies.com\/openarms\/apply-now\/","title":{"rendered":"Apply Now"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"26\" class=\"elementor elementor-26\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3e1c819a elementor-section-stretched elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3e1c819a\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;stretch_section&quot;:&quot;section-stretched&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-662a647c\" data-id=\"662a647c\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-249fc7a9 elementor-widget elementor-widget-heading\" data-id=\"249fc7a9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Apply Now<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-316d060b elementor-section-stretched elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"316d060b\" data-element_type=\"section\" data-e-type=\"section\" data-settings=\"{&quot;stretch_section&quot;:&quot;section-stretched&quot;,&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-526de211\" data-id=\"526de211\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-3838de43 elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3838de43\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-wider\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-inner-column elementor-element elementor-element-33b9bfec\" data-id=\"33b9bfec\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ccbc970 elementor-widget elementor-widget-heading\" data-id=\"ccbc970\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Supportive Housing Client Intake Form<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-aebb946 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"aebb946\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-eedf805 elementor-widget elementor-widget-spacer\" data-id=\"eedf805\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-763c96 elementor-widget__width-initial elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"763c96\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"Supportive Housing Client Intake Form\" aria-label=\"Supportive Housing Client Intake Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"26\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"763c96\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Apply Now\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"26\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-name elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDate of Intake\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_b0153e2 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_b0153e2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tReferral Agency \/ Referrer\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_b0153e2]\" id=\"form-field-field_b0153e2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_c504967 elementor-col-100\">\n\t\t\t\t\t<h4>Participant Information\n:<\/h4>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_ed13279 elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_ed13279\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tFull Name:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_ed13279]\" id=\"form-field-field_ed13279\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_5a99dec elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_5a99dec\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDOB:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_5a99dec]\" id=\"form-field-field_5a99dec\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_40ce1ef elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_40ce1ef\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAge:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_40ce1ef]\" id=\"form-field-field_40ce1ef\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_d1009f6 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d1009f6\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSSN (Last 4):\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_d1009f6]\" id=\"form-field-field_d1009f6\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_5b9f21b elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_5b9f21b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_5b9f21b]\" id=\"form-field-field_5b9f21b\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail Address:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_30b3e94 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_30b3e94\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tGender:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Male  \" id=\"form-field-field_30b3e94-0\" name=\"form_fields[field_30b3e94][]\"> <label for=\"form-field-field_30b3e94-0\">Male  <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Female  \" id=\"form-field-field_30b3e94-1\" name=\"form_fields[field_30b3e94][]\"> <label for=\"form-field-field_30b3e94-1\">Female  <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Non-binary  \" id=\"form-field-field_30b3e94-2\" name=\"form_fields[field_30b3e94][]\"> <label for=\"form-field-field_30b3e94-2\">Non-binary  <\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Prefer not to say\" id=\"form-field-field_30b3e94-3\" name=\"form_fields[field_30b3e94][]\"> <label for=\"form-field-field_30b3e94-3\">Prefer not to say<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_5b9f21b elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_5b9f21b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmergency Contact:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_5b9f21b]\" id=\"form-field-field_5b9f21b\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_87720d1 elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_87720d1\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tRelationship\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_87720d1]\" id=\"form-field-field_87720d1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_1d9282d elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_1d9282d\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPhone:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_1d9282d]\" id=\"form-field-field_1d9282d\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_b5eec39 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_b5eec39\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCurrent Living Situation\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Homeless\" id=\"form-field-field_b5eec39-0\" name=\"form_fields[field_b5eec39][]\"> <label for=\"form-field-field_b5eec39-0\">Homeless<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Couchsurfing\" id=\"form-field-field_b5eec39-1\" name=\"form_fields[field_b5eec39][]\"> <label for=\"form-field-field_b5eec39-1\">Couchsurfing<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Transitional\" id=\"form-field-field_b5eec39-2\" name=\"form_fields[field_b5eec39][]\"> <label for=\"form-field-field_b5eec39-2\">Transitional<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Jail Release\" id=\"form-field-field_b5eec39-3\" name=\"form_fields[field_b5eec39][]\"> <label for=\"form-field-field_b5eec39-3\">Jail Release<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Hospital\" id=\"form-field-field_b5eec39-4\" name=\"form_fields[field_b5eec39][]\"> <label for=\"form-field-field_b5eec39-4\">Hospital<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Other\" id=\"form-field-field_b5eec39-5\" name=\"form_fields[field_b5eec39][]\"> <label for=\"form-field-field_b5eec39-5\">Other<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_84f3fbe elementor-col-100\">\n\t\t\t\t\t<h4>Medical & Mental Health\n<\/h4>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_6aeb95e elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_6aeb95e\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDiagnoses:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_6aeb95e]\" id=\"form-field-field_6aeb95e\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_a2f4c0c elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a2f4c0c\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMedications:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_a2f4c0c]\" id=\"form-field-field_a2f4c0c\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_01cc234 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_01cc234\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAllergies:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_01cc234]\" id=\"form-field-field_01cc234\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_0438c63 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_0438c63\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSubstance Use History\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Alcohol\" id=\"form-field-field_0438c63-0\" name=\"form_fields[field_0438c63][]\"> <label for=\"form-field-field_0438c63-0\">Alcohol<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Drugs\" id=\"form-field-field_0438c63-1\" name=\"form_fields[field_0438c63][]\"> <label for=\"form-field-field_0438c63-1\">Drugs<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"None\" id=\"form-field-field_0438c63-2\" name=\"form_fields[field_0438c63][]\"> <label for=\"form-field-field_0438c63-2\">None<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-field_4e9e97e elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_4e9e97e\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDetails:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<textarea class=\"elementor-field-textual elementor-field  elementor-size-sm\" name=\"form_fields[field_4e9e97e]\" id=\"form-field-field_4e9e97e\" rows=\"4\"><\/textarea>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_b3152b1 elementor-col-100\">\n\t\t\t\t\t<h4>Legal Background\n\n<\/h4>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_7089d9f elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_7089d9f\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tParole\/Probatio\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Yes\" id=\"form-field-field_7089d9f-0\" name=\"form_fields[field_7089d9f][]\"> <label for=\"form-field-field_7089d9f-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"No\" id=\"form-field-field_7089d9f-1\" name=\"form_fields[field_7089d9f][]\"> <label for=\"form-field-field_7089d9f-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_2e19f0b elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2e19f0b\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tPO Name\/Phone:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_2e19f0b]\" id=\"form-field-field_2e19f0b\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_a8517ba elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a8517ba\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tSex Offender\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Yes\" id=\"form-field-field_a8517ba-0\" name=\"form_fields[field_a8517ba][]\"> <label for=\"form-field-field_a8517ba-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"No\" id=\"form-field-field_a8517ba-1\" name=\"form_fields[field_a8517ba][]\"> <label for=\"form-field-field_a8517ba-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_a1e5290 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_a1e5290\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tIncome Information\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"SSI\" id=\"form-field-field_a1e5290-0\" name=\"form_fields[field_a1e5290][]\"> <label for=\"form-field-field_a1e5290-0\">SSI<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"SSDI\" id=\"form-field-field_a1e5290-1\" name=\"form_fields[field_a1e5290][]\"> <label for=\"form-field-field_a1e5290-1\">SSDI<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Employment\" id=\"form-field-field_a1e5290-2\" name=\"form_fields[field_a1e5290][]\"> <label for=\"form-field-field_a1e5290-2\">Employment<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Other\" id=\"form-field-field_a1e5290-3\" name=\"form_fields[field_a1e5290][]\"> <label for=\"form-field-field_a1e5290-3\">Other<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_1211cca elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_1211cca\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tMonthly Amount: $\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_1211cca]\" id=\"form-field-field_1211cca\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_9547acc elementor-col-100\">\n\t\t\t\t\t<h4>Housing Needs\n<\/h4>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_08515f8 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_08515f8\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDisability\/Accommodation\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Yes\" id=\"form-field-field_08515f8-0\" name=\"form_fields[field_08515f8][]\"> <label for=\"form-field-field_08515f8-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"No\" id=\"form-field-field_08515f8-1\" name=\"form_fields[field_08515f8][]\"> <label for=\"form-field-field_08515f8-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_2d5e974 elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_2d5e974\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDetails:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_2d5e974]\" id=\"form-field-field_2d5e974\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_e7b546a elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_e7b546a\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tRoom:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Shared\" id=\"form-field-field_e7b546a-0\" name=\"form_fields[field_e7b546a][]\"> <label for=\"form-field-field_e7b546a-0\">Shared<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Private\" id=\"form-field-field_e7b546a-1\" name=\"form_fields[field_e7b546a][]\"> <label for=\"form-field-field_e7b546a-1\">Private<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_25c19e9 elementor-col-100\">\n\t\t\t\t\t<h4>Independent Living Acknowledgment\n<\/h4>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-field_f372345 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[field_f372345]\" id=\"form-field-field_f372345\" class=\"elementor-field elementor-size-sm  elementor-acceptance-field\" required=\"required\">\n\t\t\t\t<label for=\"form-field-field_f372345\">I understand I am responsible for my hygiene, medication, meals, transportation, and daily living<\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-field_dbfb402 elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[field_dbfb402]\" id=\"form-field-field_dbfb402\" class=\"elementor-field elementor-size-sm  elementor-acceptance-field\" required=\"required\">\n\t\t\t\t<label for=\"form-field-field_dbfb402\"> I understand this program does NOT provide medical or personal care.<\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_18c2f93 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_18c2f93\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tInitials\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_18c2f93]\" id=\"form-field-field_18c2f93\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_0778f98 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_0778f98\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDate:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_0778f98]\" id=\"form-field-field_0778f98\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-field_d0c669e elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_d0c669e\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tApplicant Signature\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[field_d0c669e]\" id=\"form-field-field_d0c669e\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" required=\"required\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-field_cf0cf84 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_cf0cf84\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tDate:\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[field_cf0cf84]\" id=\"form-field-field_cf0cf84\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Send<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t<div class=\"elementor-element elementor-element-590f251b e-flex e-con-boxed e-con e-parent\" data-id=\"590f251b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-5abf3ed8 e-con-full e-flex e-con e-child\" data-id=\"5abf3ed8\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-76beb46 e-con-full e-flex e-con e-child\" data-id=\"76beb46\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2b82f909 elementor-widget elementor-widget-heading\" data-id=\"2b82f909\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Take the First Step<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4e3e54be elementor-widget elementor-widget-text-editor\" data-id=\"4e3e54be\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tIf you\u2019re ready to create a better future and need a place that supports your journey, Open Arms Heaven is here for you.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d62b136 elementor-widget elementor-widget-button\" data-id=\"d62b136\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/projects.techhivetechnologies.com\/openarms\/contact-us\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">CONTACT US<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4ebece8f e-con-full elementor-hidden-mobile e-flex e-con e-child\" data-id=\"4ebece8f\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Apply Now Supportive Housing Client Intake Form Take the First Step If you\u2019re ready to create a better future and need a place that supports your journey, Open Arms Heaven is here for you. CONTACT US<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-26","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/projects.techhivetechnologies.com\/openarms\/wp-json\/wp\/v2\/pages\/26","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/projects.techhivetechnologies.com\/openarms\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/projects.techhivetechnologies.com\/openarms\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/projects.techhivetechnologies.com\/openarms\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/projects.techhivetechnologies.com\/openarms\/wp-json\/wp\/v2\/comments?post=26"}],"version-history":[{"count":70,"href":"https:\/\/projects.techhivetechnologies.com\/openarms\/wp-json\/wp\/v2\/pages\/26\/revisions"}],"predecessor-version":[{"id":2053,"href":"https:\/\/projects.techhivetechnologies.com\/openarms\/wp-json\/wp\/v2\/pages\/26\/revisions\/2053"}],"wp:attachment":[{"href":"https:\/\/projects.techhivetechnologies.com\/openarms\/wp-json\/wp\/v2\/media?parent=26"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}