AURI HOMES SHARED HOUSING SIGNUP FORM

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)*

First NameLast Name
Phone Number (Mobile preferred)*
Please enter a valid phone number.
Email Address (Optional but helpful)
example@example.com
Do You Need Housing For:*

YourselfA client (Case Worker)A family member
Placement Type Needed*

VeteranSenior (55+)Adult needing stable shared housingOther (please specify)
Preferred Move-In Date*

As soon as possibleWithin 1 weekWithin 30 daysOther
Do You Have Income or Program Support?*

Yes, SSI / SSDIYes, Veterans Program (SSVF, HUD-VASH, HCHV)Yes, Employment incomeYes, other housing assistanceNo incomeUnsure
City/Area You Prefer (Example: Atlanta,Buford, Lawrenceville, Norcross, Duluth, Snellville)*
Case Worker / Agency Name (Optional—if submitted by a provider)
Tell us more about your situation
How did you hear about Auri Shared Homes?*

FacebookInstagramTikTokGoogle searchReferral from a case worker or agencyHousing program referralFriend or family memberFlyer or brochureHealthcare providerOther
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