Lifesharing Form Thank you for your interest in JEVS Lifesharing. We consider requests to become a participating Lifesharing home on a rolling basis, using a thorough application and screening process. Let’s get started!First Name*Last Name*Phone Number*Email* I am Contacting Lifesharing as a:Potential ParticipantPotential ProviderPotential Referral SourceIn Which County Do You Reside?*In Which County Do You Reside?BucksMontgomeryPhiladelphiaChesterDelawareHow did you hear about JEVS Lifesharing?*How did you hear about JEVS Lifesharing?GoogleFacebookNewspaperSynagougeFriend/FamilyLifesharing ClientFlyerReferral From Another OrganizationLInkedInOtherBy submitting this form, I give JEVS Human Services consent to contact me using the above phone number and email address, and to use automated technology to call and text at the phone number above, including the wireless number if provided.