Resident Housing Application
Complete this form to apply for housing and start the screening process.
Applicant Information
Full Legal Name
*
First Name
Middle Name
Last Name
Preferred Name
Date of Birth
*
/
Month
/
Day
Year
Phone Number
*
-
Area Code
Phone Number
Email Address
example@example.com
Current City
*
Current State
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Emergency Contact
Emergency Contact Name
*
First Name
Last Name
Relationship to Applicant
*
Please Select
Parent
Sibling
Spouse/Partner
Child
Relative
Friend
Neighbor
Case Worker
Other
Phone Number
*
-
Area Code
Phone Number
Email Address
example@example.com
Veteran Information
Are you a veteran?
*
Yes
No
What branch did you serve in?
*
Please Select
Air Force
Coast Guard
Navy
Army
US Marine Corp
Space Force
Are you currently receiving any supportive services from outside providers?
*
Yes
No
which services do you currently recieve?
*
Please Select
Case Management
Home Health
Physical Therapy
Occupational Therapy
Veteran Services
Disability Support Services
Other
Please list the service(s) you recieve:
*
Current Housing Information
Current housing situation
*
Renting
Living with Family or Friends
Transitional Housing
Shelter
Hotel/Motel
Unsheltered
Other
When are you seeking housing?
*
Immediately (0–7 Days)
Within 30 Days
Within 60 Days
Within 90 Days
Flexible
Why are you seeking housing at this time?
*
Income Information
Primary source of income
*
Employment
VA Benefits
Social Security
Disability Benefits
Pension
Retirement Income
Self-Employment
Other
Estimated monthly income (USD)
*
under $1,000
$1,000 - $1,999
$2,000 - $2,999
$3,000+
Do you currently have a Payee (Someone designated to distribute your funds)
*
Yes
No
Who's your Payee?
*
Family Member
Friend
Case Manager
Other
Housing & Community Compatibility
Have you lived in a shared housing environment before?
*
Yes
No
How long did you live there?
*
Are you willing to comply with house rules, quiet hours, cleanliness standards, and community expectations?
*
Yes
No
What qualities make someone a good roommate?
*
Legal Disclosure
Are there any current legal matters that may affect your housing stability or ability to comply with community requirements?
*
Yes
No
If yes, please explain
*
Applicant Certification
BACKGROUND SCREENING AUTHORIZATION
*
I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that submission of this application does not guarantee housing approval or placement. I authorize Align Housing Solutions to verify information provided and conduct any screening necessary to evaluate my application.
COMMUNITY STANDARDS ACKNOWLEDGMENT
By checking each circle below, I acknowledge and understand & agree that:
*
I am expected to treat fellow residents, staff, vendors, and neighbors with respect.
Violence, drugs, threats, harassment, bullying, illegal activity, and behavior that disrupts the community are prohibited.
Compliance with house rules, policies, and community standards is required.
Pets are not permitted in Align Housing Solutions residences unless otherwise required by applicable law.
Failure to comply with community standards will result in corrective action, removal from the residence, or termination of housing eligibility.
Submit Application
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