Get Help

How to Apply

Step 1

Please complete the Resident Application below.

Step 2

Download the Residency Expectations when prompted and submit the form.

Step 3

The team will call you to set up a meeting to discuss your application and next steps.

Step 4

Give us a call to check on the status of your application if you have not heard from us in 24 hours 402-502-9224.

Resident Application

Contact Info.

Background

Pregnancy

You’ve indicated that you are not currently pregnant. You are not eligible to complete our resident application. Please contact Gina Tomes at 402.502.9224 with any questions you may have.

If unknown, enter "Unknown" for both first and last name.

Family History

Education

Work Experience

Most Recent
#2
#3

Faith

Relationship Status

Personal History

Legal History

How many times have you been charged with:

Housing

Identification

Substance Abuse

How many times in the last three months have your used:

Mental Health

Essay Questions

References

Agreement

Bethlehem House

2301 S. 15th St.
Omaha, NE 68108
P: 402-502-9224
F: 402-505-9016

The Humble Lily

10730 Pacific St, Suite 114
Omaha, NE 68114
P: 402-933-3366

Bethlehem House  © 2018. All Rights Reserved.