RENTAL INTEREST FORM
1. Basic Contact Info
Full Name
Phone Number
Format: (000) 000-0000.
Email Address
example@example.com
Preferred Method of Contact
Phone
Text
Email
2. Housing Need
Type of Housing Needed:
Co-Living (two per room)
Shared Housing (a room within a unit)
Studio / 1 Bedroom
2 Bedroom
Desired Move-In Timeframe:
Immediately
15-30 days
Flexible
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___________Number of Occupants
___________City or Area Preferred
3. Budget & Income Snapshot
Monthly Rent Budget (Range)
Under $800
$800-$1,200
$1,200-$1,600
$1,600+
Primary Income Source (Select all):
Employment
VA Benefits
Disability
Housing Voucher
Other Assistance
4. Co-Living Fit (Conditional Section)
Are you comfortable sharing common areas?
Yes
No
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Do you agree to house rules and shared responsibilities?
Yes
No
5. Readiness & Basic Screening
Are you able to pass a background check?
Yes
No
Do you have any past evictions?
Yes
No
Are you able to pay a security deposit if required?
Yes
No
6. Additional Info (Optional but Telling)
Anything you'd like us to know about your housing needs?
7. Consent
(This protects you legally.)
I understand this is a request for information and not a lease or housing guarantee.
I consent to be contacted regarding housing availability.
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