HDW waitlist/pre-screener

1

Status

Need to follow up with

Called/texted no answer

Current Tenant

No longer need the spot

Not a fit

In progress

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Status Notes

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Name* This field is required.

First Name

Last Name

4

Phone Number* This field is required.

Area Code

Phone Number

5

Email* This field is required.

example@example.com

6

ARE YOU CURRENTLY LIVING AT ONE OF HOUSING DONE WRIGHT LOCATIONS* This field is required.

NO

YES

7

Have you EVER been Convicted, Plead guilty to or No Contest to ANY Felonies* This field is required.

NO

Yes, non-violent felony

Yes, violent felony

8

DOES ANY OF YOUR FELONY CONSIST OF ANY OF THE FOLLOWING MURDER, ARSON, SEX CRIMES, HATE CRIMES, AGGRAVATED DOMESTIC VIOLENCE.* This field is required.

NO

YES

9

What were you charged for* This field is required.

10

What was the date of your last release from prison* This field is required.

Date

11

In the Last 5yr have you been Arrested for Any Reasons

No

Yes, but was release without charges, Dismissal, Not Guilty Verdict

Yes, but was charged with or plead to a Misdemeanor, NO Felony

Yes, on bail/bond / casing pending

12

Do you currently have any ongoing legal issues or pending court cases?* This field is required.

No

Yes, but they are minor (e.g., traffic tickets)

Yes, major issues (e.g., lawsuits, criminal cases)

13

Do you consent to a national background check as part of the application process?* This field is required.

Yes

No

14

Our shared living environment does not allow any pets or animals on the property.* This field is required.

I have no problems with this

I must have my Animal(s)

15

Do you or/have you had a history of any substance abuse problem. When was the last time you used?* This field is required.

No/Never

Yes, but in recovery for over a year

Yes, under a year but over 6 months in recovery

Yes, in recovery but have used within the last 90 days

16

Even though we are not a sober living home, if we ask you to take a drug test for illegal street drugs, would you be willing to do so?* This field is required.

Yes, I am willing to take a drug test for illegal street drugs if requested

No, I am not willing to take a drug test

17

How often do you consume alcohol?* This field is required.

I do not drink alcohol

Occasionally (monthly or less)

Weekly (1-2 times per week)

Frequently (3-4 times per week)

Daily or almost daily (5-7 times per week)

18

Have you ever been evicted from a previous rental or housing situation?* This field is required.

No

Yes, due to non-payment

Yes, due to behavior-related issues

19

Do you have a stable source of income?* This field is required.

Yes, full-time employment/SSI/SSDI

Yes, self-employed

Yes, part-time or irregular income

No, currently unemployed

20

Monthly income amount * This field is required.

21

Do you smoke cigarettes or use e-cigarettes?* This field is required.

No, I do not smoke

Yes, but only occasionally (less than once a week)

Yes, I smoke regularly but less than a pack per day

Yes, I smoke daily and usually a pack or more per day

22

Do you smoke medical marijuana?* This field is required.

No, I do not smoke medical marijuana

Yes, occasionally (less than once a week)

Yes, regularly (1-4 times a week)

Yes, daily or almost daily (5-7 times a week)

23

Do you make your bed every day?* This field is required.

Yes, I make my bed every day

I make my bed most days, but not every day

No, I rarely or never make my bed

24

How often do you do your laundry?* This field is required.

Weekly or more often (1-2 times per week)

Every two weeks

Monthly

Less than once a month

25

How often do you wash your bedsheets?* This field is required.

Weekly or more often

Every two weeks

Monthly

Less than once a month

26

How do you rate your personal hygiene in a stable living environment?* This field is required.

Excellent – I consistently maintain high standards of cleanliness

Good – I generally maintain good hygiene but occasionally slip

Average – I maintain basic hygiene but could improve in some areas

Poor – I struggle to maintain hygiene and cleanliness

27

How do you prefer to keep your living environment (your room)?* This field is required.

Very clean and organized – I consistently keep my living space tidy and organized

Somewhat clean – I keep my living space generally clean but may have some clutter

Occasionally messy – I clean when necessary, but my living space can become messy at times

Frequently messy or dirty – I struggle to keep my living space clean and organized

28

How would you rate your cleanliness on a scale of 1 to 10 when it comes to maintaining common areas?* This field is required.

10 (Excellent – I consistently keep common areas spotless and organized)

8-9 (Very clean – I generally maintain very good cleanliness in common areas)

6-7 (Moderately clean – I maintain basic cleanliness but could improve in some areas)

4-5 (Below average – I struggle to maintain cleanliness in common areas)

1-3 (Poor – I often leave common areas messy or dirty)

29

How do you feel about following rules in a shared living environment?* This field is required.

Rules are meant to be followed 100% of the time

Rules are just guidelines, and it's okay to bend them when necessary

In many situations, I don’t feel rules apply to me

30

If you noticed other housemates breaking rules, how would you respond?* This field is required.

“I would notify management to ensure the rules are enforced

“I would have a conversation with the tenant first to see if they will fix the problem before notifying management.”

“I might mention it to management, but only if it became a serious issue.”

“I would ignore it; it’s none of my business.”

31

Do you consistently act in accordance with how you describe yourself?* This field is required.

Yes, I always act as I describe myself and hold myself accountable.

No, I often find myself acting differently from how I describe myself.

32

Are you willing to help keep common areas clean and participate in doing chores?* This field is required.

Yes, I’m willing to regularly help keep common areas clean and do chores

I’m willing to help occasionally but prefer not to have regular responsibilities

No, I prefer not to help with common areas or chores

33

What is your estimated credit score?* This field is required.

750 or higher (Excellent)

700 - 749 (Good)

650 - 699 (Fair)

600 - 649 (Poor)

Below 600 (Very Poor)

34

Do you have any mental health conditions that could impact your ability to live in a shared environment?* This field is required.

No

Yes, but well-managed with treatment

Yes, and it has caused issues in the past

35

How do you typically handle conflicts with roommates or housemates?* This field is required.

I calmly discuss and resolve issues

I avoid conflict but let it build up over time

I often have heated arguments or fights

36

risk number

37

good point

38

last prison date

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Name* This field is required.

First Name

Last Name

40

Phone Number* This field is required.

Please enter a valid phone number.

41

Email

example@example.com

42

Want Type of Room are you looking for* This field is required.

As soon as anything becomes available (doesn’t matter shared or private) for 1 person max

As soon as a Private room or Large Private room becomes available, (but NOT a Shared Room) (for 1 person max)

Shared room (two HDW guest sharing one room for 1 person max) -$620mo/$155wk

Private room (for one person in a private room) -$780mo/$195wk

Large Private room/couples room( for 1 or 2 people max) -$1100mo/$275wk

43

When the large room comes available Will it be for yourself or you and one other person* This field is required.

Only for myself

For myself and one other individual

44

Name of other individual* This field is required.

First Name

Last Name

45

Phone number of other individual* This field is required.

Please enter a valid phone number.

46

If a shared room becomes available, would you be comfortable sharing the room with a person of the opposite gender?* This field is required.

Yes, Wouldn’t be a problem

Maybe

Absolutely Not -Same gender only

47

How Soon Are You Needing to moving in a Spot* This field is required.

ASAP /NOW

Select A specific date in the future

48

If Room is available, what would you like your move in date to be ?* This field is required.

Date

49

Would you prefer to make your payment weekly or monthly basis?* This field is required.

Weekly Basis -(Rent is due by Sunday before 5:00 PM)

Monthly Basis - (Rent is due by the 3rd of each month before 5:00 PM)

50

Based on you Room, Moving in Date, and preference of when rent is paid

Please Note this is a Est. and can change anytime

Your Rent is ${roomCost} on a {wouldYou}

WHAT WOULD BE NEEDED FOR YOUR MOVE IN

Your Total move-in cost would Be the {wouldYou} Pro-Rate of ${proRate}+ Refundable Depoist of ${refundableRoom} + Processing Fee of ${processingFee} = Total of ${totalMove}

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Based on you Room, Moving in Date, and preference of when rent is paid

Please Note this is a Est. and can change anytime

Your Rent is ${roomCost} on a {wouldYou}

WHAT WOULD BE NEEDED FOR YOUR MOVE IN

Your Total move-in cost would Be the {wouldYou} of ${roomCost}+ Refundable Depoist of ${refundableRoom} + Processing Fee of ${processingFee} = Total of ${totalMove}

52

Use the space to add any more information about your housing needs

0/200

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How did you hear about us* This field is required.

Google Search

Craigslist

Social Media (FB, IG,X,etc.)

Flyer/Brochure

Other

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Today Date

Date

Hour

Minutes

55

Room Cost

56

Processing fee

57

Refundable Room deposit

58

Daily Rate 2.0

59

Days Left in week

60

Days left in Month

61

month payment date Due Date

Date

62

Pro Rate Amount

63

Total Move in

64

Thank You for Your Application

We appreciate your interest in Housing Done Wright. After reviewing your information, we regret to inform you that we are unable to accept your application at this time.

Thank you for considering us, and we wish you the best in your search for housing.

65

Thank You for Your Application

We appreciate your interest in Housing Done Wright. After reviewing your information, we regret to inform you that we are unable to accept your application at this time.

Thank you for considering us, and we wish you the best in your search for housing.

Message:

“Your response went over a threshold; that’s why this is getting shown. However, you are close enough that we could re-look into this with our team on a case-by-case basis. This review process is done carefully to ensure a fair and thorough assessment.”

66

“Although your initial pre-screener did not meet our criteria, we understand that circumstances can change or that additional context might be relevant. Please use the space below to share why you believe you should be reconsidered for shared housing. We value your perspective and will carefully review any new information you provide.”

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Name

First Name

Last Name

68

Phone Number

Please enter a valid phone number.