To submit this referral form to Threshold Housing Society staff for review, please fill in as much information as possible, then press the send button at the bottom of the page. Please note, Threshold Housing provides safe housing and support services for youth and young adults ages 16 to 23 years old up until their 24th birthday. No cats or dogs are allowed at this time.

Agency Application Form

  • Referrer Information:

  • Youth Information:

  • How would this youth like to be referred to? ie: "he/him/his", "she/her/hers", "they/them/their", etc.
  • NOTE: The primary mission of the Threshold Housing Society is to provide transitional housing for youth. If a referred youth has mental health or physical challenges we can only house a youth with the appropriate external support in place prior to residency. Such supports might include a social worker, a drug and alcohol counsellor, assistance with an eating disorder or self-harm, CLBC assistance, a public health nurse, a psychiatrist, etc.
  • (ie: substance use, mental health, job support, physical disability, social skills, etc)
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    NameAgencyContact Info 
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  • References

    Please provide two references who can speak to this youth's character, including mental health and current living situation. The references would preferably be: a) a professional counsellor, social worker, outreach worker, school counsellor, teacher, etc., b) a family reference; c) an employer or co-worker
  • Thank you!

    We will be in contact with you soon.
  • This field is for validation purposes and should be left unchanged.


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