Program Application
The program application gives us information about you, your interests and your needs. The information helps us evaluate resources you might need, and referrals the program might be able to make that are outside of Jeremiah Program.
Much of this information is confidential and may be used by us to determine how to best serve your needs and those of your family. If you are uncomfortable with any question, you may omit answering it. You may also contact the Admission Coordinator’s office at 651-332-5017 for more information about any question or how this information is used.
Jeremiah Program is committed to compliance with all local, state, and federal civil rights and human rights laws that prohibit discrimination in providing educational, social service, and housing opportunities. Jeremiah Program does not discriminate against any applicant or participant on the basis of race, color, religion, creed, national origin, marital status, family status, status with regard to receipt of public assistance, physical or mental disability, or affectional preference.
Jeremiah Program does provide reasonable accommodations for persons with disabilities. Reasonable accommodations in rules, policies, practices and services will be allowed to give persons with disabilities equal opportunity to use and enjoy housing provided by Jeremiah Program or to participate in other aspects of the program, provided such accommodations do not impose an undue hardship. Applicants or program participants with disabilities seeking reasonable accommodations must contact the Director of Family Services to make an accommodation request.
Download application forms:
