Launched For Life LIVING

Housing Application

Fill the form below accurately and completely.
Name*

First NameMiddle NameLast Name
Birth Date *

MonthDayYear
Phone Number*
Email*
example@example.com
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous Address (if less than 2 years at current address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How were you referred to us?*

Referral (please specify)Web SearchAgencyFacebookInstagramLinkedInOther (please specify)
If Referral or Other:
In addition to housing, are you interested in job readiness, life skills training and/or mentoring?*

Housing OnlyJob ReadinessLife Skills Training & Mentoring
Have you ever been evicted?*

NoYes
If yes, please explain the circumstances:
Preferred Move-In Date:*

MonthDayYear
Date
I would like a ____________ bedroom*

Single - $249/week or $999/moDouble - $219/week or $849/moQuad - $195/week or $775/mo
Current Employment Status*

Full-timePart-timeSelf-EmployedUnemployed, but looking for workStudent
If unemployed or a student, how will you pay your housing fee?
Have you ever been charged or convicted of a felony?*

YESNO
If YES, please explain:
EMERGENCY CONTACT
References

Please list two references that are familiar with you personally or professionally.
Reference*
Reference*
Launched For Life (LFL) residents live in fully furnished apartments in Uptown Charlotte. This is a temporary arrangement, and not a lease, sublease or sublet. I agree to sharing the common areas (living room, dining space, kitchen and bathrooms) with other like-minded adults in my assigned unit. I agree to maintain my living space according to LFL standards. I have reviewed and agree to abide by the LFL Housing Expectations. I commit to submitting the housing fee on time and understand the housing fee converts to a daily fee if payments are received after the due date.*

YES
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Housing Application