Mae’s Loving Arms, LLC Application Form
Mae’s Loving Arms is a housing-only organization dedicated to providing safe, respectful, and structured shared living environments for adults seeking stability and a fresh start. We honor Mae’s life and legacy by offering housing that promotes security, independence, and peace of mind. We serve: Elderly adultsAdults with intellectual or developmental disabilities (IDD, Adults with physical disabilities who can independently complete activities of daily living (ADLs, Veterans in need of transitional support, and Returning citizens (re-entry population). Mae’s Loving Arms provides housing only and supports each resident’s right to choose any qualified third-party provider for services they may need.
Applicant Name
First Name
Last Name
Date of birth
-
Month
-
Day
Year
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you smoke?
Yes
No
Are you a Convicted Felon?
Yes
No
Income & Employment Information
SSI
SSDI
Employment
Veterans Benefits
other
Emergency Contact
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Reference
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Notes
Proof of Income
Employment/Income Proof
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Employment Letter, Two Months Pay Stubs, etc.
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What Payment Method do you plan to use?
Cash
Zelle
Venmo App
Square Cash App
Paypal
Google Pay
Other
Move-in Cost/ Payment Method
Are you able to pay four rent upfront?
Yes
No
If no please explain?
Are you able to pay a one-time, non-refundable, move-in/move-out/key set-up fee?
Yes
No
If no please explain?
ID or Driver license:
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Signature
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