If you — or someone you know — would like to stay at Wellington Women's House, fill in our online referral form below.
- If you’re applying to stay at the House yourself, make sure you provide as much information in the form as you can.
- If you’re completing the form on behalf of someone else, fill in as much information as possible, preferably alongside the applicant. Unless you indicate otherwise we’ll contact the applicant directly to make a booking for an assessment if deemed suitable.
If you'd prefer to print and then fill in a paper copy of the form, you can download it here and email it to us at [email protected] when complete.
Wellington Women's House referral form [PDF 116KB]