Welcome to The Village Living

Welcome to The Village Living

Welcome to The Village Living, a transitional housing program operated by JAM Legacy Group LLC. We are committed to providing a safe, structured, and supportive environment where single individuals and families can rebuild, grow, and work toward long-term independence.This onboarding form will collect the information needed to enroll you in the program and review the policies you agree to follow during your residency.Please answer each question honestly and completely. Your information will be kept confidential and used only for program administration and support services.Completing this form does not guarantee acceptance into the program until all requirements have been reviewed and approved.
Client Full Legal Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Upload A Copy of the Front and Back of your Drivers License

Cancelof
Current Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Marital Statue
Will any children reside with you at The Village Living?
Number of Children Enrolling With You
Please list each child's full name and age.
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to You

Program Enrollment Information

This section helps us understand your current housing situation, employment status, and your goals while participating in The Village Living.
What type of room are you requesting?
What is your desired move-in date?

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Are You Currently Employed?
If employed, please provide your employer's name, position, and work schedule.
Upload 2 Most Recent Income Statements

Cancelof
Provide All Other Verifiable Income

child support, disability benefits, retirement, vouchers and any other source of income not listed.
Cancelof
If you are not currently employed and do not have an exemption describe your plan for obtaining employment within the next 14–30 days.
Do you currently have a checking or savings account?
Are you willing to maintain an active savings account while participating in the program?
Please describe the top three goals you hope to accomplish during your stay.
Examples: Obtain stable employmentSave for permanent housingImprove financial stabilityComplete educational or vocational trainingStrengthen parenting skillsImprove overall well-being
How long do you anticipate needing transitional housing?
Certification

Employment, Financial Responsibility & Program Commitment

The Village Living is designed to help residents achieve long-term independence. Clients are expected to actively participate in employment, financial planning, and personal goal achievement throughout their stay.
Employment Commitment
Employment Requirement
Saving Commitment
Financial Responsibility
Program Participation
Drug Testing Policy
Why are you seeking to participate in The Village Living, and what are you committed to doing to make this opportunity successful?
Client Certification

Program Fees & Financial Agreement

The Village Living requires residents to contribute toward the cost of housing and program operations. Please review each statement carefully before continuing.
Program Processing Fee
Monthly Program Fee(provided after approval into program)
Monthly Program Fee Due Date (Discussed after approval)
Financial Responsibility
Late Payment Policy
Returned Payment
Financial Communication
Financial Acknowledgment

I understand my financial responsibilities while participating in The Village Living and agree to comply with all payment requirements.
Certification

Privacy, Consent & Client Acknowledgments

Please review the following acknowledgments carefully. These statements explain how your information is handled, how we communicate with you, and your responsibilities as a participant in The Village Living.
Privacy & Confidentiality
Emergency Contact Authorization
Communication Consent
Do you authorize The Village Living to use photographs or videos of you for educational, promotional, grant reporting, or program-related purposes?
Resident Handbook Acknowledgment
Policy Updates
Accuracy of Information
Is there anything you would like program staff to know about your situation, needs, goals, or accommodations before moving into The Village Living?

Client Certification & Electronic Signature

By signing below, you acknowledge that you have completed this onboarding form, understand the requirements of The Village Living, and agree to comply with all program policies throughout your participation.
I certify that all information provided in this onboarding form is true and complete to the best of my knowledge. I understand that providing false or misleading information may affect my eligibility to participate in The Village Living.

I acknowledge that I have read and understand the program expectations, financial responsibilities, house rules, employment requirements, savings expectations, and all policies contained in this onboarding packet.

I understand that participation in The Village Living is contingent upon continued compliance with program requirements and policies.
Client Agreement
Electronic Signature Consent
Client Electronic Signature
Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate Signed
Should be Empty:

Program Enrollment Information