Housing and Disability Assistance Program
Self Referral

We are Here To Help!
Brian Gonzalez
(707) 468-1336 Ext 131
 

HDAP Self-Referral Form

Non-Consortium members will be considered
Date of Birth(Required)
Address(Required)
Explain your housing situation, employment, disabilities or any relevant information

we review every application we receive

I applied, now what?

Northern Circle has received your application and now you’re curious about what you should do? We’ll contact you! 

Depending on which application you submitted with NCIHA, a staff member of that department will review and verify your application and reach out to you about your submission. We will receive your application the day you submitted it through our website or fax; 3-5 business days by mail, and will begin processing you into our system. It takes up to 10 business days to receive a response about your application. 

In the meantime, if you have a change in your information, such as a change in contact information, please reach out to us so we can update your application and prevent any delays in processing.

Email: receptionist@nciha.org

Mail: 694 Pinoleville Dr. Ukiah CA

Phone: (707) 468 1336