The Refuge in Otsego County - Gaylord, MI - Request Help for Yourself

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First Name

Last Name

Email

Phone

What is your connection to Otsego County? *

resident until becoming homeless

born here and returned

came here to live with family

Current Situation *

I/we are currently without any shelter for tonight

I/we are living with friends or family

How many are in your family? Please list number of adults and number of childen.

Do you have any pets?

What is the best way to reach you?

We received your form and will get back to you soon. Thank you!

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Phone

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