AURI HOMES SHARED HOUSING SIGNUP FORM
Safe, Stable, Affordable Shared Living. Please complete this short form to begin the placement process or to get more information.
Full Name (First and last name)
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First Name
Last Name
Phone Number (Mobile preferred)
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Please enter a valid phone number.
Email Address (Optional but helpful)
example@example.com
Do You Need Housing For:
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Yourself
A client (Case Worker)
A family member
Placement Type Needed
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Veteran
Senior (55+)
Adult needing stable shared housing
Other (please specify)
Preferred Move-In Date
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As soon as possible
Within 1 week
Within 30 days
Other
Do You Have Income or Program Support?
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Yes, SSI / SSDI
Yes, Veterans Program (SSVF, HUD-VASH, HCHV)
Yes, Employment income
Yes, other housing assistance
No income
Unsure
City/Area You Prefer (Example: Atlanta,Buford, Lawrenceville, Norcross, Duluth, Snellville)
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Case Worker / Agency Name (Optional—if submitted by a provider)
Tell us more about your situation
Start My Housing Application
Should be Empty: