Join the Divine Freedom Living Community: Prescreen/Waitlist Form

Join the Divine Freedom Living Community: Prescreen/Waitlist Form

Please fill out this form to express your interest and help us understand your housing needs.
Full Name*

First NameLast Name
Pronouns*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
E-mail*
example@example.com
Date of Birth*

MonthDayYear
Date
Preferred Move-In Date*

MonthDayYear
Date
Location Preference*
Housing Preference*
Guaranteed Income Source*
YesNo
Total Monthly Income amount?*
Monthly Housing budget? (How much are you trying to spend on your room rent per month?)*
When would funds be available for move in?*
What is your benefit date? (What day do you receive your money) or What day of the week do you get paid from your job?
Support Needed*
Currently unhousedLiving with friends/familyStaying in a shelterAt risk of losing housingOther
Where are you staying right now?*
YesNo
YesNo
Please tell us a little about yourself, any medical, mobility, personal needs or support you may require, and why you’re interested in joining Divine Freedom Living?*
Referral Source/ How did you hear about us?
Thank you for your interest in Divine Freedom Living Residences. We appreciate you reaching out to join our community. A member of our team will follow up with you when a space becomes available or if any additional information is needed to move forward.
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