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- Which housing are you interested in?*
- Who Are You Sumbitting This Pre-Screening Form For?*
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Format: (000) 000-0000.
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- Preferred Contact Method*
- Preferred Room Type*
- Desired Move-In Timeframe*
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- Source of Income*
- Do you currently have any pets or animals that you intend to bring with you?*
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- Eviction History - Have you had an eviction filed against you within the past 7 years?*
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- Criminal History - Have you had any criminal convictions within the past 7 years?*
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- Court Orders - Are there any current court orders for probation, parole, supervision requirements, or other restrictions that may affect your housing or move-in process?*
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- 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?*
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- Please review and acknowledge the following program qualifications and disclaimer. To continue with the pre-screening process, each item below must be checked:*
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- Should be Empty: