RBP Solutions Housing Waitlist Form
Phone: 443-799-5435| Email: Dakickback895@gmail.com
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Emergency Contact
*
First Name
Last Name
Emergency Phone:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Move-in Date:
*
-
Month
-
Day
Year
Date
Room Type:
*
Shared Room - $550/month
Private Room - $950/month (furnished)
Private Room -$750/month (unfurnished)
How many people:
*
Ages of dependents (if any):
*
Social Security Number
*
Date of Birth
*
-
Month
-
Day
Year
Date
Background Check
Please fill Out in Full details..
Current Housing Situation:
*
Employment Status:
*
Monthly Income (USD)
*
Household Size
*
References Name #1
*
First Name
Last Name
References Email #1
*
example@example.com
References Phone Number #1
*
Please enter a valid phone number.
Format: (000) 000-0000.
References Name #2
*
First Name
Last Name
References Email #2
*
example@example.com
References Phone Number #2
*
Please enter a valid phone number.
Format: (000) 000-0000.
References Name #3
*
First Name
Last Name
References Email #3
*
example@example.com
References Phone Number #3
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reason for Assistance
*
0/100
Please Upload ID
*
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Paystubs/Budget Letters
*
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REQUIREMENTS ACKNOWLEDGMENT
*
I understand Full Rent +$250 deposit is due at Move in
I can provide pay stubs within 24-48 hours
I'm available for in-person intake interview (5900 York Rd Suite 107A Baltimore MD 21212)
I agree to background/reference check
All Weekly,Daily,Monthly Rentals Agrees to terms and conditions.(None Payment is Subject to Automatic Termination of the Program.)
I Have Uploaded My Valid ID & Income
"Commitment required for chosen term" or "Rate changes require new application".
I Have Completed The Appointment Booking Link to Come in Person.
Preferred Interview Time Next Move In Appt Times: Mondays & Wednesdays
Preferred Interview Time Next Move In Appt Times: Mondays & Wednesdays
*
Please Select
9:00 AM
10:30 AM
12:00 PM
1:30 PM
3:00 PM
4:30 PM
Preferred Interview Time Next Available Appt: Saturday & Sundays
Please Select
9:00 AM
10:30 AM
12:00 PM
1:30 PM
3:00 PM
4:30 PM
Signature
*
Date Submitted
*
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Month
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Day
Year
Date
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