Tree of Life Shared Living Program Application
Complete this form to apply for the shared living program, including your personal details, current situation, and agreement to house rules.I understand that if approved, a non-refundable program deposit will be required to secure placement in the shared living program. A program coordinator will be in contact with the applicant/case worker upon submission.
Personal Information
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Identification & Documentation
Which of the following documents do you have?
*
Birth Certificate
Social Security Card
State ID or Government ID
Current Situation
Describe your current living situation.
*
What is your move-in timeline?
*
Immediately
1 week
2 weeks
Income & Stability
What is your primary source of income?
*
Employment
SSI
Disability
Veteran Benefits
Unemployment
Other
Are you currently employed?
*
Yes
No
Monthly income amount
*
Do you receive food benefits (SNAP)?
*
Yes
No
Are you working with any programs or caseworkers?
*
Yes
No
If yes, provide organization/case worker contact info:(short answer)
Do you have steady income?
*
Yes
No
Transportation
Do you have a vehicle?
*
Yes
No
Payment Agreement
Are you able to consistently pay the monthly program fee, fee can range from 1000.00 to 1500.00 monthly utilities included.
*
Yes
No
Are you willing to enroll in automatic monthly payments?
*
Yes
No
Independent Living Requirements
Are you able to live independently?
*
Yes
No
Do you require medical care or supervision?
*
Yes
No
Shared Living Compatibility
Are you comfortable sharing a room and common areas?
*
Yes
No
Do you agree to keep shared spaces clean and remain sanitary?
*
Yes
No
House Rules Agreement
I agree to the following house rules:I understand this is a shared living environment I understand this is not a traditional rental agreement I agree to follow house guidelines and expectations I understand cleanliness and daily hygiene are required I understand homes are one gender only (no mixed genders) I understand steady income or payment arrangement is required
*
yes I agree, and understand
No I don't agree, and understand I will not be able to move forward with this program because of this.
Background Information
Do you have any criminal background?
*
Yes
No
If yes, please explain.
Placement Preference
Which home are you applying for?
*
Women’s home
Men’s home
Location Confirmation
Property ZIP CODE IS 75241 Main streets near location are Bonnie View/Camp Wisdom near Dallas Va medical Center
I confirm this location works for me.
*
I confirm this location works for me
Personal Statement
Please describe your situation and what you are looking for in a stable living environment.
*
Agreement Section
I understand this is a shared living program and NOT a lease or rental agreement. I confirm I can live independently, agree to all house rules including hygiene, curfew, and visitor policies, and agree to consistent program fee payments including automatic payments if accepted.Our shared living homes are fully furnished and designed to provide a clean, structured, and supportive environment. Residents are not required to bring furniture, as all essential furnishings are provided.To maintain a safe and sanitary living space, all residents must follow our cleanliness standards. A bed bug prevention policy is strictly enforced, and all clothing and personal items must be properly cleaned prior to move-in.This is not a co-ed living environment. All homes are single gender only. Drugs and alcohol are strictly prohibited on the premises.
*
I agree to the above statement
Submit Application
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