Initial Inquiry
This is a pre-application inquiry and does not guarantee eligibility or admission.
Section 1 - Prospective Resident Information
Name
*
First Name
Last Name
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is the applicant over the age of 22 and/or have they graduated from their high school program at the time of this inquiry?
Please Select
Yes
No
* If an applicant is under the age of twenty-two (22) or has not graduated from their high school program at the time of inquiry, staff shall place the individual on a separate prospective interest list for future consideration. Placement on this list does not constitute placement on HCL's active waitlist or guarantee future eligibility or admission. Individuals may be invited to complete the formal application process upon reaching eligibility age.
Applicant is:
Applying independently
Applying with guardian support
Applying with family support
Applying with case manager/provider support
Contact Preferences
Please tell us who we should contact and the best way to reach them regarding this inquiry (e.g. contact the prospective resident by phone, contact the guardian by email, etc..)
Section 2 - Support Contacts (if applicable)
Add the applicant's primary support contacts, such as a guardian, parent, SSA, family member, or other support person.
Primary Contact Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Relationship
Optional: We'd love to get to know you! Please share anything you'd like us to know about yourself or the prospective resident, such as hobbies, interests, favorite activities, personality, likes and dislikes, goals for independent living, or anything else you think would help us get to know you better.
Acknowledgment
I acknowledge:
I understand HCL is an independent housing community that requires the ability to live with a roommate and does not provide healthcare, personal care, case management, supervision, or therapeutic/behavioral services. HCL does not provide furnished units or supplies needed to live.
I understand that residents are responsible for arranging any outside services or supports they may choose to use.
I understand this inquiry does not guarantee housing availability, eligibility, or placement.
I understand that HCL complies with applicable fair housing and disability rights laws, and reasonable accommodations may be requested at any stage
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