Becoming a Host Home Provider with Region V Systems
IMPORTANT: This is a federally funded grant, serving the following rural counties: Adams, Butler, Cass, Clay, Fillmore, Gage, Jefferson, Johnson, Lancaster (NOT the city of Lincoln), Nemaha, Nuckolls, Otoe, Pawnee, Polk, Richardson, Saline, Saunders, Seward, Thayer, Webster, and York. Host Home Provider applicants must reside in one of these counties to be eligible to participate in our program.
The first step is to complete the Host Home Provider Application below (Note: instructions to sign a release for us to conduct your background check will come later, inclusive for all members of the household age 19 and above).
Don’t want to complete on-line? No problem! You can click on the “Printable Application” button below to have the option of downloading the application to complete by hand. Your handwritten application can be provided as follows:
- Attach to your e-mail and send to: email@example.com
- Mail to: Region V Systems, c/o Host Homes Program, 1645 N St., Lincoln, NE 68508.
Next steps in the application process:
- You will receive e-mail confirmation that your application was received.
- Your application will be assessed to ensure you are able to meet the minimum requirements to become a Host Home Provider.
- If you meet the minimum requirements, you will be contacted to schedule an interview and complete a home inspection.
- Once the home inspection and interview has been completed, we will conduct a background check on everyone 19 or older in the household. Thereafter, you will be contacted regarding our feasibility to move forward with your application.
- The last step is to schedule a 6-hour orientation session, which is required to become a Host Home Provider.
- You will be matched with a young adult as soon as possible.
If, at any time during this application process it is determined that you do not meet the current needs of the Host Homes Program, you will be notified in writing.
Questions? E-mail firstname.lastname@example.org or call Dani DeVries at 402-441-4351.
Thank you for your interest, and we look forward to receiving your application!
This application is for Host Home Providers only. If you are a young adult experiencing homelessness, please contact Dani DeVries at (402) 441-4351 or at email@example.com.
Please note the application does not save if you close the browser before you submit the application — you will lose your work! Please gather information about your previous employment, addresses, and phone numbers ahead of time to prepare for the application process.