Snow Belt Housing
Rental Pre-Application
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
PO BOX or APARTMENT NUMBER- Street Address
City
County
Postal / Zip Code
Tenant info
Names of all household members that contribute to income:
Source of income for each household member:
Total monthly income for each tenant:
What is the total yearly income for everyone in the household?
How many people live in the household?
Is anyone age 60 or over?
Yes
No
Does anyone have a disabling condition; to include a physical disability?
Yes
No
Are you currently receiving housing assistance?
Yes
No
Are you currently on the waiting list for one of our properties?
Yes
No
Are you current with your utility companies?
Yes
No
Has anyone in the household been convicted of a felony?
Yes
No
Has anyone in the household been convicted of any drug charges?
Yes
No
Does anyone in the household smoke?
Yes
No
Do you have any pets?
Yes
No
Type of apartment desired:
Location?
Number of bedrooms?
Upper or lower unit?
Amount of rent you can afford?
Do you need an accessible unit?
Signature
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: