Speak With Love Foundation Corp. International
Homeowner Housing Program Registration
Homeowner Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Method of Contact
*
Please Select
Phone
Email
Upload a copy of a valid picture ID
*
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Property Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Property Information
Property Type
*
Please Select
Single Family (split level)
Ranch
Townhouse
Condo
Apartment
Rental Options
*
Please Select
Entire Home
Private Room/s (Single person per room)
Shared Room (2 people maximum per room)
Notes: List any other details about your property or rental options.
Number of Rooms Available
*
Monthly Rent (per room or full unit)
*
Additional notes on prices is applicable.
List any utilities that are included in the monthly fee. If none, then type NA.
*
List any furniture and appliances included in the monthly fee. Note: all appliances MUST be in working condition. (If none, then type NA)
*
Do you currently carry homeowners insurance on this property?
*
Please Select
Yes
No
Upload a snapshot of proof of ownership or permission to rent or lease the property. Eg. Mortgage statement, deed, lease agreement etc.
*
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Does the home have stairs?
*
Please Select
Yes
No
If Yes, Please explain and list the number of stairs
*
Is the home wheelchair accessible? - (Wheelchair accessibility is not required to participate in the program.)
*
Please Select
Yes
No
How soon will your property be ready for move in?
*
-
Month
-
Day
Year
Date
We provide service to Veterans, Seniors 55+ and Survivors of Domestic Violence. Choose the group that you are willing to offer housing to:
Please Select
Veterans
Seniors 55+
Survivors of Domestic Violence
Males Only
Women Only
Women with children
Any
Referred By: List who referred you or how you found out about us. If you know neither, put N/A
*
Choose which service you wish for us to provide to you.
Referral Service Only [We find and place residents in your home, you manage them]
Referral and Resident Management Services
Rent Your Entire House to operate our Housing Program
Pets are not allowed. However, support animals with the proper documentation will be allowed. Will you accepts individuals with a documented support animal?
Please Select
Yes
No
Program Participation Acknowledgment
By submitting this form, I understand and agree that: *Residents placed in the 'Referral & Resident Management' option remain active participants in the Speak With Love Foundation housing program. *Program guidelines and housing standards must be followed. *Applicable referral or management fees will be disclosed prior to placement
*
I read, understand and agree
Homeowner Certification
I certify that the information provided above is accurate to the best of my knowledge and understand that submission of this form does not guarantee placement.
*
I Agree
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