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Request Shelter

*For youth up to age 18 who are experiencing homelessness or displacement from the home of a guardian.

YOUTH INFORMATION

Who is completing this form?

REFERRAL INFORMATION (ONLY IF YOUTH IS NOT COMPLETING THIS FORM)

Thank you. A staff member will be in touch. If you need immediate assistance, please call 1-800-532-8192.

Our Supporters & Affiliates

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1414 W. San Antonio St.

New Braunfels, Texas 78130

830-629-6571

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