BCR Tenant Application

Tenant Pre-Application Form
Please be aware that we plan to have an in-house cat fostering program for tenants who wish to do this program & who also meet the requirements.

If you are allergic to cats or wish to not live with them, you must make that clear on this form. We do not allow tenants to bring animals in with them, but we do work with a local rescue to volunteer & foster cats.
Personal Details

Your Details:
Full Name:*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age
E-mail:*
Phone:*
Current Living Situation

Your Current Address:
Current Residential Status*

Private TenantLiving with FamilyProperty OwnerOtherHomelessCouch Surfing
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employment Details:
Employment Status*

EmployedSelf EmployedUnemployedStudent
Annual Income from employment*
Start date of employment
Confirmation Employment Will Remain For Duration Of Tenancy*

YesNo
Any other income sources?
Person, Disibility. Social Security, Other
How do you plan to pay your rent if approved?
Background
Are you a smoker?*

YesNo
Do you have any children under 18?*

YesNo
Are you currently in a relationship?
Sexual Orientation
Gender
List any disabilities (If applicable)
Do you have a valid license?
Do you own a vehicle legal to drive on the road?
If you plan to use this vehicle during your stay
Anything else we should know about you?
Proposed Tenancy & Declaration
Proposed Start Date of Tenancy*

MonthDayYear
Date
Desired Length of Tenancy
Alcohol & Drug Use
List Of All Past Used Substances
List All Rehab/Outpatient/MAT Attempts & Dates
What Does Your Current Sobriety Program Look Like?
Example: Methadone dosing daily & AA Meeting daily
Date Of Last Drug Use / Drink?
Dates for all substances
Details of current clinic you attend (If applicable)
Location, frequency, & phone number
Legal Issues
Please describe all past arrests & outcomes
Do you have an open or current legal obligations?
Describe any community service requirements?
Do you have any violence-related charges towards humans or animals?
Are you currently on probation? Their contact info?
Are you seeking sober living due to legal issues?
Cat Questionnaire
Are you allergic to cats?

YesNoUnsureOther
Are you ok living with cats?
Are you interested in fostering any cats (If you meet criteria & space is available.)
Do you have interest volunteering at a nearby cat rescue?
This does NOT determine eligibility to live with us. But please be honest.
List all animals you own & will have ownership once you leave the house
Do you need to surrender any animals?
We may have resources to help you
List any charges you have against animals
Confirm*

I hereby verify that all information completed on this pre-tenancy questionnaire is correct and true
Should be Empty:

Tenant Pre-Application Form

Personal Details

Current Living Situation

Employment Details:

Background

Proposed Tenancy & Declaration

Alcohol & Drug Use

Legal Issues

Cat Questionnaire