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
Can you verify this income?
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
Please select any that apply to your current situation

Other
Where are you staying right now?
Any history of sex-offender registration or violent charges? (This does not disqualify you)
Do you have a case manager?
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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