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For Women and Children

Polly’s Place

Polly's Place provides safe, temporary housing and supportive services for women experiencing homelessness, helping them build stability and prepare for independent living.

Program Overview

Information Sheet
Polly's Place Website

Housing Features

  • Up to 5 bedrooms available
  • In-house rules must be followed
  • Support services provided
  • No charge until the third Monday of stay
    • $50.00 a week starting the third Monday of stay
    • $60.00 a week starting the twelfth Monday of stay
  • Alcohol and drug-free environment

Eligible Applications

Eligible applicants must be females, 18 years or older and at risk of being homeless. Priority is given to Ottawa County residents. Residents must remain alcohol and drug free and are subject to random drug testing. Residents shall sign a weekly lease agreement and must follow various house rules which may include but are not limited to engaging in treatment services, maintaining employment, volunteering for the community and following curfew times.

The Goal

Polly’s Place aims to provide safe housing with necessary
supports to assist individuals with the progression to
independent living. Polly's Place is a six-month program
with the option for an extension, if necessary.

Application Form

All prospective female applicants should complete the Resident Application Form as the first step in the application process. After reviewing the application, the Polly's Place staff will determine whether the applicant is eligible for an interview.

The online application is submitted directly to Polly's Place staff upon completion. If you choose to use the PDF application, complete the form and email it to Pollysplace@oakhouse-pc.org.

If you have questions about the application process, call 419-341-2828.

Fields marked with * are required.

Download Application Form (pdf)
Polly's Place - Resident Application Form
Current Residential Address
Current Residential Address
City
State/Province
Zip/Postal
Do you have a valid Driver’s License?
Do you have your own transportation?
Do you have health insurance?
Do you have any handicap/ accessibility needs?
Please check all that apply to you
Have you ever served in the military?
Do you have a significant other?
Do you have children?
Do you have custody of your children?
Do you have children under the age of 18 that currently live with you?
Are you in recovery from alcohol and/or other drugs?
Substance of Choice (check all that apply):
Are you currently receiving substance abuse treatment?
Are you currently on Medication Assisted treatment?
Do you need assistance in accessing substance abuse treatment?
Would you like us to play an active role in your treatment process?
If YES, Release of Information Form shall be completed by the resident.
Are you a registered sex offender?
Have you ever been charged with a sex offense?
Have you ever been diagnosed with a mental illness?
Are you currently on any mental health medications?
Do you currently have any health problems that we should be aware of?
Are you taking any medication for your health problems?
Have you ever lived in a Transitional/Recovery House?
Are you employed?
Do you need assistance finding employment?
Do you have the ability to pay rent?

($50 per week the first 90 Days (starting 3rd Monday of stay))

($60 per week the first 90 Days (starting 12th Monday of stay))

Would you engage in developing a transitional plan and update it as needed?

Attestation

I hereby attest that I understand (please check)