Home Alast Residential | Host Application & Vetting Questionnaire
HOST APPLICATION
Vetting & Screening Questionnaire for Veteran Housing Participation
Application Date: June 27, 2026
This application gathers detailed information to vet and screen every prospective Host, ensuring that veterans placed through Home Alast Residential live in a safe, secure, and well-managed environment. All information is confidential. Fields marked with * are required. Falsification of any information is grounds for immediate disqualification.
1 Host & Business Identification
Individual Host Name (Person Responsible for the Home) *
*
Business Name (if applicable) *
*
Relationship to Property (Owner, Manager, Officer, etc.)
Phone Number *
*
Format: (000) 000-0000.
Email Address *
*
example@example.com
Date of Birth *
*
-
Month
-
Day
Year
Date
Government-Issued ID Number (Driver's License/State ID) *
*
Mailing Address (Street, City, State, ZIP) *
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2 Landlord / Operator Experience
Years of Experience as a Residential Landlord *
*
Years of Experience Managing Co-Living / Shared Housing
Do you currently manage any other rental or residential properties? *
*
Yes
No
If yes, how many properties do you currently manage?
Have you previously housed veterans, sober-living residents, or participants in any other supportive housing program?*
*
Yes
No
If yes, please describe (program name, duration, outcome):
Home Alast Residential Confidential Page 1 of6
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Home Alast Residential | Host Application & Vetting Questionnaire
Home Alast Residential • Confidential • Page 2 o16
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3 Property Information & Type
Property Address (Street, City, State, ZIP)
*
Number of Bedrooms
*
Number of Bathrooms
*
Total Square Footage
*
Year Built
*
Parking Spaces Available
*
Maximum Resident Capacity
*
Property Classification
*
Residential - Single-Family Home
Residential - Multi-Family / Duplex / Apartment
Commercial Property (e.g., hotel, motel, boarding house)
Other
If Other or Commercial, please describe the property type
Housing Type Offered Through Home Alast
*
Independent Living Home (single-family residence)
Independent Living Facility (multi-unit)
Co-Living / Shared Space Housing
Transitional Housing
4 Veteran Population Served - Housing Designation
Home Alast Residential operates gender-specific homes. Please indicate exactly which veteran population this property will house. A property may only be designated for one gender category to maintain program safety standards.
This property will house (select one):
*
Male Veterans Only
Female Veterans Only
Age Population This Home Is Suited For (select all that apply):
*
Young Adult Veterans (18-30)
Middle-Aged Veterans (31-59)
Elderly Veterans (60+)
All Adult Age Groups
Does this property have any physical features suited for elderly or mobility-limited veterans?
Wheelchair Accessible
Single-Story / No Stairs
Grab Bars / Modified Bathroom
Stairlift or Elevator Access
None of the Above
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5 Property Ownership & Lease Status
Property Ownership Status *
*
I OWN this property
I RENT/LEASE this property
If you OWN the property: Is the property fully paid off, or is there an active mortgage?
Paid Off (No Mortgage)
Active Mortgage
Length of Your Lease Agreement (e.g., 12 months, month-to-month)
Lease Start Date
-
Month
-
Day
Year
Date
Lease End Date / Renewal Date
-
Month
-
Day
Year
Date
If leased, do you have written permission from the property owner to sublease or use the property for this housing program?
Yes - documentation attached
No - will obtain before approval
Not applicable (I own the property)
Property Owner / Landlord Name (if you are leasing)
Property Owner / Landlord Phone Number (if you are leasing)
Format: (000) 000-0000.
6 Property Condition & Safety
Current Occupancy Status *
*
Vacant - ready for immediate placement
Currently occupied - will be vacant by:
Under renovation - estimated completion:
Does the property have working smoke detectors and a fire extinguisher on site?*
*
Yes
No - will install before placement
Utilities Included in Rent (check all that apply)
Electricity
Water / Sewer
Gas
Trash / Recycling
Wi-Fi / Internet
Cable / TV
Describe any recent renovations, repairs, or improvements made to the property
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7 Transportation & Resident Support
Per the Home Alast Residential model, transportation to VA appointments, medical visits, and essential services is provided by the Host and further supported by our program's coordination team.
Are you able to provide or arrange transportation support for residents? *
*
Yes - host-provided transportation available
Yes - with coordination from Home Alast
Limited - please describe below
Describe your transportation capability (vehicle availability, schedule, etc.)
8 Criminal Background & History Disclosure
DISQUALIFYING OFFENSES: Hosts with a history of violent crimes or sexual offenses are NOT eligible to participate in this program. All information below is subject to formal background check verification. Falsification of any answer is grounds for immediate and permanent disqualification.
Have you ever been convicted of a felony of any kind? *
*
Yes
No
Have you ever been convicted of a violent crime (assault, battery, domestic violence, robbery, homicide, or similar offense)?*
*
Yes
No
Have you ever been convicted of a sexual offense of any kind?*
*
Yes
No
Are you currently registered, or have you ever been required to register, as a sex offender in any state or jurisdiction?*
*
Yes
No
Do you have any active warrants, pending criminal charges, or open court cases?*
*
Yes
No
Have you ever had a restraining order or protective order filed against you? *
*
Yes
No
Have you ever been evicted from a property you owned or managed due to a legal dispute, code violation, or similar issue?*
*
Yes
No
Do you consent to a full criminal background check as a condition of this application?*
*
Yes
No
If you answered YES to any question above, please provide a full explanation including dates, jurisdiction, and current status: Explanation
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9 Personal & Professional References
Please provide two references who can speak to your character and reliability as a property host or landlord (not family members).
Reference 1
Full Name *
*
Relationship *
*
Phone Number *
*
Format: (000) 000-0000.
Reference 2
Full Name *
*
Relationship *
*
Phone Number *
*
Format: (000) 000-0000.
10 Host Acknowledgment, Consent & Signature
By signing below, I certify that all information provided in this application is true, accurate, and complete to the best of my knowledge. I understand that Home Alast Residential will conduct a property inspection, a criminal background check, and reference verification prior to final approval. I understand that a formal Host Agreement will be executed before any veteran is placed in my home, and that falsification of any information in this application is grounds for immediate and permanent disqualification from the program.
Host Signature *
*
Date *
*
-
Month
-
Day
Year
Date
Printed Name *
*
Business Name (if applicable) *
*
FOR OFFICE USE ONLY
Background Check Completed:
Property Inspection Date:
Decision:
Approved
Pending
Denied
"Serving those who served us."
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