Make a Comforts of Home Referral | United Way of Northeastern Minnesota

UWNEMN's Comforts of Home program is meant to be a one-time use program.

If your client has mitigating circumstances, please contact sarah@unitedwaynemn.org to discuss further.

Name

Company

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Client Information

Client Name

Please check this box if your client has used the Comforts of Home program in the past.

Number of Adults in Household

Ages of Adults in Household

Number of Children in Household

Ages of Children in House

What community will this family or individual be living in?

Please enter a rough estimate of the family or individual's yearly income:

Please describe this family or individual's crisis and why they are being referred to the Comforts of Home program.