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Contact

Welcome to My Father’s House of Greensboro!


Our mission is to provide a safe and nurturing environment for young adults who have aged out of the foster care system.


We aim to support you in your journey toward independence by teaching life skills, offering mentorship, and sharing God’s grace and love.


Please complete this form to help us better understand your needs and how we can assist you.

Personal Information

Date of birth
Month
Day
Year
Gender

Emergency Contact

Program Needs

Check all areas where you are seeking assistance

What's your current situation?

Are you currently employed?
Do you have stable housing?
Do you have reliable transportation?
Are you currently enrolled in school or training?
Yes
No

Background Information

Have you aged out of the foster care system?
Yes
No
Do you have any dependents?
Yes
No
Do you have a support system? Family, Friends, Church, etc.
Yes
No
Are you working with a Social Worker?
Yes
No
May we contact them?
Yes
No

Goals and Aspirations

Your Health & Well-being

Do you have any Medical Conditions or Disabilities we should be aware of?
Yes
No
Are you currently receiving Counseling or Therapy?
Yes
No
Are you currently receiving Medicaid?
Yes
No

Faith & Mission Alignment

As a faith-based organization, we extend God’s love and grace through Biblical discipleship. Are you open to participating in spiritual activities, such as Bible studies or mentorship programs?
Yes
No
Undecided

Additional Information

Signature

Put your name in the box. Thank you

Date of Submission
Month
Day
Year
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