Waitlist Application Form

  • Waitlist Application Form

    Before completing this form, you must have a minimum income amount of $850/mo. Comfort Hopes Independent Living
  • Gender*
  • Desired Move In Date*
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  • Is your previous address one of the following?*
  • What type of situation most likely relates to you?*

  • Are you over the age of 65?

  • Housing Preferences And Needs

  • Are you looking for a room for a single adult?*
  • What is your room preference?*
  • Are you okay with co-ed housing? (e.g.,some locations are co-ed houses)*
  • Do you require any type of assistance?*
  • Do you need any assistance with the following?

  • Are you currently taking any prescribed medications?*

  • Income and Benefits

  • What is your source of income?*
  • What is your monthly housing budget?*
  • Do you receive Food Stamps EBT / LINK (SNAP benefits)?*

  • Lifestyle and House Rules

  • Are you willing to follow house rules (e.g., no drugs, no unapproved guests, curfew, quiet hours, cleanliness)?*
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  • Do you have any pets?*
  • Smoking Status?*
  • Do you have reliable transportation?
  • Services you are interested in
  • Resources you are interested in

  • Background Screening

    This section is to get to know your situation better and you will not be judged or denied based solely on this section.
  • Have you ever been evicted from a previous residence?*
  • Have you ever been convicted of a felony?*
  • Are you a registered sex offender?*
  • Are you currently on Probation or Parole?*
  • Have you ever been arrested?*

  • Documents

    Must submit the most recent documents or send documents via email at info@comforthopes.com
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  • Acknowledgement and Signature

  • Acknowledgement Statement

    I understand that Comfort Hopes Independent Living is a housing and placement agency and own, operate, or manage housing. Submission of this form does not guarantee housing placement. All housing decisions are made by independent housing operators based on their criteria, availability, and approval processes.

  • Today's Date*
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  • Closing Notice

    Thank you for completing the Waitlist Housing Application. Submission does not guarantee placement. Availability depends on openings with independent housing operators. Submission is valid for one year.

  • Should be Empty: