• Under 62 - Shared Housing Referral

    We can refer you to a shared housing home that accepts people under 62
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  •  -
  • When are you looking to move in? (Funds are due at move in) *
     - -
    2 digit month, 2 digit day, 4 digit year
  • Income Source*
  • What part of town are you interested in?*
  • Are you homeless or at risk of being homeless?*
  • Will you be on parole or probation?*
  • Are you looking for a shared room or private room?*
  • I understand there is a maximum of 2 people per room (one per bed).*
  • I am referral from
  • I am willing to do a background check*
  • I am seeking housing for*
  • I understand no pets are allowed due to allergies and safety of all occupants*

  • NOTE: Most shared housing properties DO NOT allow smoking, drinking or overnight guests. 

     I UNDERSTAND THIS IS FOR REFERRAL. 

  • Should be Empty: