To Apply for Housing
Note: we are one of many housing agencies in Honolulu. Our programs are not tailored to assist you indefinitely. You must apply for and access public or low income housing. Also, explore resources to increase your income and/or skills to be less dependent on our programs.
Eligibility Criteria
• Hawaii residency;
• Homeless or at-risk of becoming homeless;
• Very-low income limits and limited resources/assets;
• Be actively receiving case management services;
• Able to live independently.
• HIV/AIDS Diagnosis (if applicable)
• Homeless or at-risk of becoming homeless;
• Very-low income limits and limited resources/assets;
• Be actively receiving case management services;
• Able to live independently.
• HIV/AIDS Diagnosis (if applicable)
Application and Documentation
Fill out the Full Application ending 2020 (which includes the two-page application and Consent to Services, Case Management Representation, HIV/Medical, Consent to Exchange Information forms) and provide the following applicable documents:
• 2 photo IDs, and something that shows your social security number
• Residency verification (e.g. a current lease, ID, or statement with a Hawaii address)
• HIV certification (If applicable, by a Hawaii licensed doctor, or we accept other Hawaii AIDS Service Organization form)
• Case Management Representation (your case manager must complete this form)
• Income Verification (bank statement, paystub or SSA/DHS statement, etc.) or complete the Zero Income Affidavit form
• Proof of homeless or at-risk situation (homeless shelter/outreach worker verification, eviction/termination/late notice, discharge plan, or that you pay more than 40% of your gross income towards rent)
• (Oahu only) If applying for emergency assistance or temporary shelter, also complete the Ryan White Client Agreement and Case Management Services Certification form.
If you have applied in the past, the first three items may be skipped; other documentation may be required on a case by case basis. Click on the links above to print the application/form or get a copy at our office or from your case manager.
Incomplete applications will not be processed. After you turned in a completed application, you should be notified with an outcome. If you were not notified, call the Executive Director, Jon Berliner, at 808.592.9022 or email.
• 2 photo IDs, and something that shows your social security number
• Residency verification (e.g. a current lease, ID, or statement with a Hawaii address)
• HIV certification (If applicable, by a Hawaii licensed doctor, or we accept other Hawaii AIDS Service Organization form)
• Case Management Representation (your case manager must complete this form)
• Income Verification (bank statement, paystub or SSA/DHS statement, etc.) or complete the Zero Income Affidavit form
• Proof of homeless or at-risk situation (homeless shelter/outreach worker verification, eviction/termination/late notice, discharge plan, or that you pay more than 40% of your gross income towards rent)
• (Oahu only) If applying for emergency assistance or temporary shelter, also complete the Ryan White Client Agreement and Case Management Services Certification form.
If you have applied in the past, the first three items may be skipped; other documentation may be required on a case by case basis. Click on the links above to print the application/form or get a copy at our office or from your case manager.
Incomplete applications will not be processed. After you turned in a completed application, you should be notified with an outcome. If you were not notified, call the Executive Director, Jon Berliner, at 808.592.9022 or email.
To Access FoodBasket Services
Note: The FoodBasket is closed during the first week for home grocery deliveries. It is open Tuesdays and Thursdays during the rest of the month; sign up between 11 am and 12 pm at the First Baptist Church, 1313 Pensacola Street, at Kinau Street (Map it). Our volunteers will get you oriented and started.
1) Bring the Certification of Case Management Services form on first visit (signed by a Hawaii Health and Harm Reduction Center case manager).
2) Register your name/check in (each time to pick up groceries).
3) Sign the Ryan White Client Agreement and Code of Conduct form (must be updated annually).
1) Bring the Certification of Case Management Services form on first visit (signed by a Hawaii Health and Harm Reduction Center case manager).
2) Register your name/check in (each time to pick up groceries).
3) Sign the Ryan White Client Agreement and Code of Conduct form (must be updated annually).