-
-
- Who Are You Sumbitting This Pre-Screening Form For?*
- Which housing are you interested in?*
-
-
Format: (000) 000-0000.
-
- Preferred Contact Method*
- Preferred Room Type*
- Desired Move-In Timeframe*
-
-
-
- Source of Income*
- Do you currently have any pets or animals?*
-
- Have you had any evictions or criminal convictions within the past 7 years that may affect housing eligibility?*
-
- Are there any current court, supervision, or program requirements that may affect your housing or move-in process?*
-
- Are you currently required to register as a sex offender?*
- Are you currently receiving support or services from a case manager, social worker, or agency?*
-
- Please review and acknowledge the following program qualifications and disclaimer. To continue with the pre-screening process, each item below must be checked:*
-
-
- Should be Empty: