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Abuse Shelter Residency Application

This application can only be completed on a Desktop, Laptop, or Tablet. 

This application can only be completed on a Desktop, Laptop, or Tablet. 

We're extremely humbled you've trusted us with this potential next phase of your life. Our abuse shelter residency application is very meticulous as we continuously strive to best serve and understand the many needs of the public. The application process allows our organization to conclude the best resources we have to ensure that we are indeed sufficient to all our resident's needs. The application is confidential (never public). Application processing may take up to 48 hours. Upon application completion a determination email will be sent to the email the applicant has on file. We ask that you kindly explore your spam folder if you believe you have not had an application update after the initial 48-hour processing period. Please add to your email contacts upon successfully submitting your application.


The “Abuse Shelter Residency Application” is the form domestic violence survivors are required to submit when applying for abuse shelter residency. This form may be completed by a domestic violence survivor, or a trusted third party on behalf of a domestic violence survivor. A trusted third party may be a close family member, friend, peer, church, etc. who has permission to help submit an application on a potential resident’s behalf. Third parties should never submit an application without first, the approval of the applicant. Applicants may also come into any of Luvernes Safe Haven, Inc.'s public offices to get and submit an application for the abuse shelter residency program. 

I. Abuse Shelter Residency Program Overview

Luvernes Safe Haven, Inc. welcomes women and their accompanying children (under age 16) from within any of the 50 United States of America and the District of Columbia (Washington D.C.) to apply for residential stay. Our residency program is located in the state of Georgia and we kindly welcome domestic violence survivors from state-to-state. Applicants are required to thoroughly read and complete the application as the first step to acquire domestic violence abuse shelter residency.


Our residency service is accommodated with a variety of essential programs. One of our main and mandatory in-house programs is affectionately called "Seed-to-Soil". We operate within its guidelines daily and it helps to examine and acquire healthy emotional, mental, physical, psychological, and spiritual states of wellness. This program is extended to our residents upon program completion. It incorporates on-demand 24-hour advocacy support, counseling, social works, and therapy for individuals and families. Our program residents are provided a personalized-nondiscriminatory experience in support of their current and future needs and goals. The length of the program (duration) is determined within our resident's needs, allowances, and will. We do not set time limits to one's healing, and are always committed to give our residents our absolute best. Our in-house advocates serve as a team of support and are always available.  

II. Qualifications

Potential abuse shelter residents are asked to provide proof that they are in a current or potential domestic violence relationship.

            Required forms of proof are:

  • Filed police report(s) detailing claims of abuse.

  • Hospital record (s) of abuse documented as domestic violence.

  • Photos documented as proof of domestic violence abuse.

  • Text messages (screenshots) confirming abuse has occurred from the abuser

  • Witness Testimony.


If the above required forms of proof are not obtainable, applicants should explain why they don’t have those forms of proof in speaking with a member of the organization in person or by phone. Upon speaking with a staff member, we'll respectfully visit this area for required documentation. We understand in some cases the above forms of proof may be hard to obtain. We encourage applicants to still complete the application and explain their particular situation upon our follow-up process. 

Applicants should not have any outstanding warrants or any legal obligations in which by entering the program and abuse shelter home would interfere with required adherence.


Applicants who have jury duty obligations outside of Ware County, Georgia should highly consider reaching out to the appropriate agency to request a dismissal of the service, only upon program approval and applicant's program acceptance. This should be handled after being contacted and confirmed that you have been approved for our abuse shelter residency program. A member of staff may contact the agency on your behalf to confirm program residency. Organizational transportation services are not guaranteed for out-of-town jury duty obligations.

Background Checks

All approved applicants who have also been approved for our abuse shelter residency program will be required to submit to a background check. This will include any accompanying children additionally. The purpose of the background check is to inform and educate the organization on its potential residents and make all necessary adjustments. You will not undergo a background check unless and until you've received a phone call follow up interview, and has agreed to enter the abuse shelter residency program. It is only then we will confirm your permission to undergo a criminal background check and proceed. Solely submitting this application does not require a background check. Information discovered within a background check will not prohibit a residency offer.

Drug Intervention Services

All approved applicants who accept our residency offer will undergo an evaluation their first week. This evaluation will include a drug test and a mental health evaluation. Upon our follow up call interview, we will revisit this mandatory requirement and document any addictions or drug use. Residency determination is not based on an applicant's drug history or use. However, if an applicant has shared that they have a drug addiction problem, they must commit to an outpatient drug treatment program as a condition of acquiring residency. 

III. Approvals & Disapprovals

Approval of applications are determined by three factors.

3.1 The applicant or trusted third party unequivocally provided extreme reasoning for needing domestic violence abuse shelter residency.

3.2 The applicant or trusted third party completed every question as required and successfully submitted the application to Luvernes Safe Haven, Inc. This means that no section was left blank. For questions that did not apply, or there was no answer, applicants or trusted third parties listed “N/A” as required.

3.3 Finally, the applicant signed their name in regular print (not cursive) on each document as required. This is for paper application submissions only. 


Application approval does not mean "residency approval". Application approval confirms that based off of the information you've provided you are a qualified candidate for our residency program. Residency approval comes after parts I & II of the application have been submitted, reviewed, and followed up with a phone interview. The application on this webpage is Part I of the application process. For security purposes part II of the application process is only provided after a follow up interview to part I has been completed. If during the first follow up phone interview an applicant desires to proceed to the next part, our part II application link will be provided through email. For application submissions that are submitted by paper, part II applications can also be provided and submitted by paper upon requests. For part II applications that are accessed through an email provided link, the application will require a passcode. A unique passcode will be provided and is time sensitive. The passcode will expire 48 hours after being sent out. If part II application is not completed within the allotted time, the application will expire and will require a 6-month waiting period to reapply for residency. 

Once Approved

Residents who are approved for residential stay at the abuse shelter home are expected to obtain abuse shelter residency within 7 days of residency approval. Approved residency applicants who may not be able to obtain physical residency within 7 days must make the organization aware immediately in which a new date if permissible may be extended. No applicant once approved will have more than 2 weeks (14 days) to obtain residency for any reason. If residency has not been acquired within a 14-day window from the original application approval date, applicants will be removed from the program. At that time applicants are not allowed to reapply for abuse shelter residency until after 6-months and 14 days from the original approval date. For these reasons’ applicants are encouraged to apply when they are 100% prepared to enter the abuse shelter residency home. Luvernes Safe Haven, Inc. will attempt to contact residency approved applicants' multiple times within the 48-hour window. If unsuccessful in reaching applicants after 48 hours of attempting to, applications will be denied and applicants are not allowed to reapply for abuse shelter residency until after 6-months and 14 days from the original approval date.


Waiting List Approved Applications

The only instance in which an approved applicant who is on the waiting list will receive a call back from Luvernes Safe Haven, Inc. is when they are the very next person in line to move into the abuse shelter home. All other communications will be through email.

Disapprovals or rejection of applications may happen if one or more of the following occur.

3.4 A physical copy of an application was submitted and not signed (in print) and dated as required.


3.5 Applications failed to prove an extreme need for Luvernes Safe Haven, Inc.'s domestic violence abuse shelter residency services.


3.6 An application was submitted with a perceived reasonable accommodation that will unfortunately cause an undue hardship to the organization.


3.7 An applicant or third party submitting an application on behalf of an applicant attempted to return it either by email, fax, or physical mail yet it never arrived to the organization. 

All disapproved or rejected applications will receive a follow-up response and explanation as to the reasons of disapproval or rejection within 48 hours of submission unless it falls under section "3.7".

Reasons under section "3.7" will be unknown to the organization until and unless an applicant contacts the organization in inquiry of an application that has not been received. If an application inquiry falls under section "3.7" upon conclusion we kindly ask that the applicant or trusted third party acting on behalf of the applicant complete the application online. Applicants who receive a disapproved or rejected application update may reapply based on the rejection reason. If an applicant has failed to create extreme reasoning for needing shelter in the disapproved or rejected first submitted application, yet can currently establish an acceptable reason for acquiring abuse shelter residency, a new application should be submitted. In all cases if the rejection reasoning is something that can be modified applicants should reapply with the modifications.

Application interim Questions?

3.8 Can I request a call back instead of an email update to know if my application was not approved?

Unfortunately, we do not permit callbacks for approved or unapproved domestic violence abuse shelter residency applications. All communications will be through the email that was provided on the original application. 

3.9 If I don’t have an email what other way can I find out that my application was not approved?

Unfortunately, we only offer email communication in terms of communicating application status? We do not send rejection letters through physical mail or rejection communications through text messaging as we consider this service confidential. Sending a rejection letter to a home address or via text messaging violates our company's policy. Even upon request from the applicant we cannot send physical mailed rejection letters or text about approved or unapproved applications. Phone calls are not permitted for updates on application status as it too violates our confidentiality and safety protocols for abuse shelter residency applicants.


Waiting List & General Questions?

1. How many applicants may be on the waiting list at once?

All approved applications will automatically go on the waiting list. The number of approved applicants on the waiting list will vary as the organization will not know how many applications will be submitted and approved. Approved applications are "Part I" applications that were approved for completing the next steps (Part II Application). In any case approved or disapproved domestic violence abuse shelter residency applications statuses will be notified with a determination letter via email.  


2. Why don’t all approved applicants on the waiting list get a call back since their applications were approved? 

Luvernes Safe Haven, Inc. accepts abuse shelter residency applications from across the United States of America. We have partners across the country to which applicants in different states may have been referred to apply to our domestic violence abuse residency program directly from another partnering organization. We receive a large number of applications and communications for the many different services we provide. If our domestic violence abuse shelters are near to or at full capacity it is considered more of an inconvenience to applicants to call every applicant who was approved when the likelihood of actually moving into the abuse shelter home is unlikely within the next 4-6 months. The average survivor’s residency duration is expected to be between 4-6 months. Applicants are looking for shelter as soon as possible. And although we're constantly growing our abuse shelter capacities, when near to or at maximum capacity it is too risky to hold up the possibility of an applicant to receive shelter elsewhere in the interim of our organizational growth. This is why all submitted applications are followed up through email, which includes their waiting list position.

3. Why not close off applications when at or near abuse shelter capacity to avoid a large pile up of approved applicants waiting for a residency offer?

Our domestic violence abuse shelter residency application portal is always available for a variety of reasons such as organizational training, our partnership requirements, legalities, and most importantly to offer abuse shelter residency to survivors. When we're at full capacity we will state that we're currently not accepting applications. An opening can occur at any time, and we're always working to expand our residency capacities.

 4. Will approved applications on the waiting list expire?

Yes. Applications that are approved yet on the waiting list expires after 90 days of submission. 

5. Why do approved applications on the waiting list expire?

Luvernes Safe Haven, Inc. accepts domestic violence abuse shelter requests (applications) from all 50 of the United States of America. It is with deep regret that some approved applicants may not be able to acquire our residency program due to unavailable rooms amid our domestic violence abuse shelter homes. We encourage all applicants to apply at different abuse shelter residency programs in addition to ours.


6. If my application was approved and I received an email stating that I was on the waiting list, yet 90 days have passed without any callback do I have to complete another application if I still wanted to apply for or needed abuse shelter residency with Luvernes Safe Haven, Inc?

Yes. You should submit another application just as you did previously in the understanding that the same rules and procedures will apply.

IV. Program Completion

Program completion signifies that all needed organizational resources have been successfully provided and utilized. Survivors have completed all of the necessary steps to restore their lives and have successfully set path to positively change the trajectory of their lives. Program completion is a different journey for each individual survivor. The timeframes of completion will thereby vary based upon one's specific necessities. 


V. Program Dismissal

Luvernes Safe Haven, Inc. has the right to terminate the program at any time for any reason. Program termination or dismissal will typically occur if a house resident refuses to comply with organizational rules and regulations. Offences such as sharing the abuse shelter’s physical location is a violation that warrants automatic program dismissal as it puts employees, other house residents, volunteers, and the organization in grave danger. It could also come with legal ramifications. Program dismissal requires the house resident and all accompanying children of the individual to physically leave the premises of the abuse shelter home and all prior obligations are voided.

Program dismissals may occur if a house resident decides themselves to not complete the domestic violence abuse shelter residency program. Self-program dismissals will terminate the residency agreement and reapplying could be allowed 6 months after program exit.


VI. 1st week Mandatory Procedures

Applicants upon acquiring residency must undergo a drug test screening and mental health wellness evaluation within their first 3 days of shelter occupancy. Applicants are not discriminated against nor rejected if experiencing extensive drug use or addiction. Approved residents must complete all additional paper work discussed within the first follow up phone call interview on their first day of shelter occupancy.  More in-depth mandatory processes will be made known upon the first follow up call.  

VII. Application

Authorization Code
You must create an authorization code to establish a secure point of reference to discuss the status of your application. This code will be used whenever your application is being discussed in person or by phone. Your unique authorization code should be the first four digits of your social security number and the number of your residential address.  You are not required to show your social security card at any time, though to discuss any inquiries and updates on your abuse shelter residency application you must reference the authorization code you created in this application. If you don't have a social security number, please use the first four numbers of your Tax I.D. #. Your Tax I.D. should match the information on your state issued identification card. Please reference the example below as an example of how your authorization code should be determined. 

Authorization Code Example

Customer's Address:
123 Main Street
Waycross, GA 31501

Customer's Social Security or Tax I.D. # 987-65-4321

Authorization Code: 9876123

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