Yellow House Pre Application Please enable JavaScript in your browser to complete this form.YOU MUST BE PREGNANT AND/OR HAVE AN INFANT CHILD TO PARTICIPATE IN THE YELLOW HOUSE PROGRAM. The Yellow House Program is only for young ladies ages 16 - 21 years old. If you are older than that, or a male, please complete the REACH Langley application. What is your age? *Name *FirstLastAre you currently homeless? *YesNoEmail *Contact Number *Is this your number? *YesNoIf no, who's number is it?Are you pregnant? *YesNoDo you have infant children? *YesNoIf yes, how many and what's their ages?Why do you want to be part of The Yellow House? *Is there anything else you'd like us to know?Submit