Refuge House Application

Download and print the entire application here


to fill it out on the computer, please continue below.


While living at Refuge House I agree to:

  • Treat others with respect, kindness, and equality. I agree to respect other women’s confidentiality and to own their past decisions as well as their privilege to learn from them.

  • Respect the property of Refuge House and the property of the other residents of Refuge House. This includes the personal space of others and their physical being.

  • I will give the House Manager $100 from my first W2 check as a security deposit which will be returned to me when it is time to transition to independent living. The return of the full $100 is contingent upon my leaving my room clean upon inspection and complete with all room contents provided to me while residing at Refuge House.

  • When leaving Refuge House it is my responsibility to provide the Refuge House Manager with my forwarding address so that my security deposit or a portion of it can be sent to me.

  • Handle disagreements positively, respectfully, and with forgiveness. The House Manager is able to help residents learn conflict resolution skills.

  • Respect others by choosing positive language as my form of personal expression. In a Christ-centered home, foul language is not good modeling for children, nor is it good character development for strong women developing their parenting skills.

  • Attend worship services together.

  • Attend weekly goal sessions.

  • Attend Refuge House Programs which have been arranged to help me reach my full potential.

  • To follow the house guidelines outlined in this application to the best of my ability. These guidelines are the same for all residents.

A Place of Refuge Ministries of South WI, Inc. is a 501(c)3 non-profit corporationand a Recognized Service Organization of the Lutheran Church-Missouri Synod. EIN: 39-1971929

©2013-2020 A Place of Refuge Ministries of South Wisconsin, Inc.

Proudly created with

Pregnancy Hotline:

(414) 476-6333

Blessed Again Resale: 

7624 W. Hampton Avenue
Milwaukee, WI  53218
(414) 464-9099

Office Phone:

(414) 438-2767