Online Housing Application Form

Online Housing Application Form

We're glad you're here. This form helps us learn your needs and match you with the right housing. Please be honest—your story matters, and we're here to offer second chances to those ready for a fresh start.
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Date
To help us match housing options appropriately, how do you describe your gender?*

MaleFemaleNon-binaryPrefer not to sayPrefer to self-describe
Current Address (If Applicable)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Are you currently employed?

YesNo
Current Employer
Length of Employment
Monthly Salary (After Taxes)
If you are not currently employed, please list the sources of income you receive—such as SSI, SSDI, pension, veteran benefits, or other support.
Monthly Income from other sources?
If you currently have no income, will you be using a housing voucher, or do you have someone who can sponsor or assist you financially?

YesNo
Please provide the name of the company or individual sponsoring you. If you have a sponsor, be sure to click the link below and complete the sponsorship form.
Sponsorship Form
I acknowledge that only verifiable income is accepted, and I confirm that all sources listed are accurate and supported by appropriate documentation.*

I Agree
Preferred Move-in Date

MonthDayYear
Do you have pets?*

YesNo
Have you ever been evicted?*

YesNo
Have you ever been convicted of a felony?*

YesNo
Do you have an active warrant?*

YesNo
Do you have any pending cases within the State of Texas?*

YesNo
If you answered yes to any of these questions, please explain:
We provide housing with both private and shared room options. Are you comfortable living in a shared home with others?*

YesNo
We are a second-chance housing program committed to helping individuals rebuild. While we strive to offer opportunities to everyone, eligibility is still based on specific criteria, and not all applicants may qualify. Please share why you believe you deserve a second chance, and help us understand the circumstances that have brought you to this point. Your story matters and we want to hear it.*
By submitting this application you agree: 1) The information provided herein is complete and accurate. Providing incomplete and/or false information could result in the rejection of the application. 2) Submission of this application does not guarantee a room lease, which is reserved only upon signing of a completed lease agreement by all parties. Additionally, no other agreements, either written or oral, are binding on applicant, owner or owner's agents until the completed lease agreement is signed by all parties. 3) Additional information may be required in order to process your application. Our management team will contact you upon receipt of this online application to obtain any additional information necessary to complete the processing of your application.
Confirm*

I Agree
Signature*

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