Columbia Housing Center Registration Form
Please complete this form that will provide the Columbia Housing Center the information necessary to begin assisting you with your apartment search. The Columbia Housing Center's mission is to champion and sustain thriving, racially integrated communities in Columbia. Information provided in this form is confidential and will not be shared with property managers or owners. Our free rental referral resource will help you explore parts of Columbia you may not have known about. Our staff will help you find rental options that meet your needs and align with our mission. The Fair Housing Act, 42 U.S.C. 3601 et seq., prohibits discrimination by direct providers of housing, prohibits discrimination concerning the sale, rental, and financing of housing based on race, religion, national origin, sex, handicap, and family status. A primary goal of the Fair Housing Act is to achieve a housing market in which a person's background does not arbitrarily restrict access. The Fair Housing Act is in place to protect buyers and renters from seller and landlord discrimination. Fair Housing is a core tenet of the Columbia Housing Center and our apartment referral program.
Name
*
First Name
Last Name
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Best Phone Number To Reach You
*
Please enter a valid phone number.
Email
*
example@example.com
Best Time to Contact You
*
Morning
Afternoon
Evening
MONTHLY Total Combined Household Income (before taxes)
*
Monthly Rental Budget (30% of monthly income)
This field is calculated automatically
Are you a full time student and receiving housing assistance through loans and/or parental support?
*
Yes
No
Credit score (if known)
If you do not know your exact credit score, please select your current credit rating
Good
Average
Poor
I'm not sure
No credit score established
How much do you currently pay for your monthly rent?
*
When is the earliest date you can move?
*
-
Month
-
Day
Year
Date
When is the latest date you can move?
*
-
Month
-
Day
Year
Date
Total number of persons (including children) to occupy rental unit?
*
Total number of bedrooms desired?
*
Do you require pet-friendly listings?
*
Yes, allows cats
Yes, allows dogs
No
If you said "Yes, allows dogs", please specify the number of dogs and their weights & breeds.
Are there other special requirements or amenities requested?
What village(s) are you interested in moving to?
*
Dorsey's Search
Harper's Choice
Hickory Ridge
Kings Contrivance
Long Reach
Oakland Mills
Owen Brown
River Hill
Town Center
Wilde Lake
Unsure
Are you using a Housing Choice Voucher?
*
Yes
No
If yes, which Housing Authority provided the voucher?
Are you receiving any type of case management or navigation services?
*
Yes
No
If yes, what organization or agency have you been working with? Please provide a contact name if possible.
Are you a female head of household (the member of the family who has been designated by the family as the head for purposes of determining income eligibility and rent)?
*
Yes
No
Are you (or another household adult) of Hispanic / Latinx ethnicity?
*
Yes
No
Are you (or another household adult) of Arab or Middle Eastern ethnicity?
*
Yes
No
Racial Identity: Please indicate the race of adults living in the household.
*
You
Other Adult (1)
Other Adult (2)
White: A person having origins in any of the original people of Europe, the Middle East, or North Africa
Black / African America: A person having origins in any of the black racial groups of Africa or the Caribbean
Asian: A person with origins in any of the peoples of the Far East, Southeast Asia, or the Indian subcontinent including for example: Afghanistan, Bangladesh, Cambodia, China, India, Japan, Korea, Laos, Malaysia, Mongolia, Pakistan, Philippine Islands, Thailand, and Vietnam
American Indian / Alaskan Native: A person having origins in North, Central or South America who maintains a tribal community attachment (not just claim of ancestry)
Native Hawaiian / Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa or other Pacific Islands
American Indian or Alaska Native AND White
Asian AND White
Black / African American AND White
American Indian / Alaska Native AND Black / African American
You accept disclosure of your new address (or nearest cross streets) as terms of agreement for our service.
*
Clear
Submit
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