STOP RENT Intake Form

STOP RENT Intake Form

Please fill out the form to help us understand your current housing situation and your desired home conditions.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Preferred contact method:
If phone contact chosen, pick preferred time for a call or text (mornings not available):
Current Housing Conditions
Do you live in a house or apartment?
How many bedrooms?
How many bathrooms?
How much is your current rent? (in $)
How many people live in your current residence? Specify number of adults and children.
What is your monthly combined income? (in $)
What is your current credit score?
Desired Housing Conditions
How many bedrooms do you need?
How many bathrooms do you need?
How many stories do you want?
Do you prefer a garage?
What is the most comfortable monthly mortgage payment for you? (in $)
Additional Comments or Preferences
Signature
Please verify that you are human
Should be Empty:

Current Housing Conditions