Mahal's Haven Waitlist Form

Mahal's Haven Independent Living - Waitlist Application

Opening Spring 2026. Completion of this form does not guarantee placement. Submission places the applicant on the Mahal’s Haven Independent Living waitlist
Full Legal Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Are you applying for yourself or someone else?*
Who is this application for?*
Are you a referral partner?*
Desired Move In Timeline *
Preferred Room Type*
Can you comfortably afford the preferred room type you've selected?*
Source of Income *
Have you ever been convicted of a violent offense? *
If yes, please explain otherwise type N/A *
Have you ever been convicted of: *
Are you currently on *
Brief description of reason for housing needs or situation *
DISCLAIMER

Mahal’s Haven Independent Living is a shared housing program serving the Metro Atlanta Area. Exact location details are provided upon placement consideration. Submission of this form does not guarantee acceptance or placement.
Should be Empty:

Mahal's Haven Independent Living - Waitlist Application