Shared Housing Program Inquiry

Space and Grace Solutions Shared Housing Inquiry
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Email
example@example.com
Phone Number*

Area CodePhone Number
When are you looking to move in? *

MonthDayYear
Date
CentralNorth HoustonEast HoustonSouth HoustonWest HoustonCypress/TomballKatyOtherFirst Available
What is your total monthly income? *
SSDISSIVAPensionDisabilityEmploymentOtherFamily Guarantor
YesNo
YesNo
YesNoJust clicking
VACommunity OutreachReentrySocial WorkerSocial MediaCurrent ParticipantOther
YesNo
YesNo
Please provide P.O. contact information, if applicable
Do you have a subsidy or voucher from an agency? If so, please provide details.
YesNo
YesNo
YesNo
YesNo
YesNoJust clicking
YesNo
Please attach your proof of ability to pay (Redact any sensitive data)

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Is there anything else you'd like to share?
NOTE: Our shared housing properties DO NOT allow smoking, drinking, pets or overnight guests.

You are responsible for your own food, transportation, medication reminders, money management, toileting, showering and cooking.

***There is a $250 move in fee + monthly program fee due at time of move in. We do not accept promise to pay.
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Space and Grace Solutions Shared Housing Inquiry