Tenant Application Form

Harbor Halo Membership Housing™ Waitlist

Information collected on this form is used to help match individuals with available homes and layouts. Placement decisions are made later based on availability and home features.
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Best way to contact you*

Phone callText messageEmail
Current Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Eligibility & Fit
Age Range*
Are you a U.S. Veteran?*

YesNo
Can you live independently without daily assistance?*

YesNo
Financial Snapshot
Monthly Income Range*
Primary Income Source*
Housing Preferences
Preferred Location*
Are you currently housed?*

Yes, stable housingTemporarily staying with family/friendsHotel / short-term stayCurrently unhoused
Desired Move-In Timeline*

ASAPWithin 30 days60–90 daysJust planning ahead
MOBILITY / ACCESSIBILITY — CONDITIONAL LOGIC (UNIT FIT ONLY)
Which best describes your mobility needs?*

I can go up and down stairs without assistanceI can use stairs with some difficultyI need a ground-floor roomI use a wheelchair or mobility device
PETS / ANIMALS — CONDITIONAL LOGIC (DATA ONLY)
Do you currently have any animals living with you?*

NoYes
How many animals do you have?

123 or more
What type of animals do you have?

DogCatOther
Are any of these animals an Emotional Support Animal (ESA) or Service Animal?

YesNoNot sure
Anything you’d like us to be aware of regarding your animals?
Additional Information or Requests
Referral Information
How did you hear about Harbor Halo?*
Were you referred by an agency or case manager?*

YesNo
Soft consent checkbox
I agree to be contacted by Harbor Halo regarding housing availability.*

I agree
Should be Empty:

Harbor Halo Membership Housing™ Waitlist

Eligibility & Fit

Financial Snapshot

Housing Preferences

MOBILITY / ACCESSIBILITY — CONDITIONAL LOGIC (UNIT FIT ONLY)

PETS / ANIMALS — CONDITIONAL LOGIC (DATA ONLY)

Referral Information

Soft consent checkbox