Home Alast Residential | Co-Living Housing Waitlist Application (Non-Veteran Applicants)
Welcome
Thank you for your interest in Home Alast Residential's co-living housing community. This short form adds you to our waitlist so our team can contact you as soon as an approved co-living home matching your needs becomes available. No sensitive personal information is required at this stage.
Please Note
This application is for non-veteran applicants interested in co-living / shared-space housing opportunities with Home Alast Residential. Veterans should complete the separate Veteran Housing Waitlist Application.
1 Contact Information
Name
*
First Name
Last Name
Phone Number *
*
Format: (000) 000-0000.
Alternate Phone (optional)
Format: (000) 000-0000.
Email Address (optional)
example@example.com
City / State / ZIP Code
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2 Co-Living Housing Preferences
Gender (for gender-specific housing placement) *
*
Male
Female
Age Group *
*
18-30
31-59
60+
Do you have any accessibility needs? *
*
No
Yes - wheelchair accessible
Yes - single story / no stairs
Yes - other
3 Current Situation
Back
Next
Current Housing Situation *
Current Housing Situation *
*
No permanent address
Staying with family or friends
In a shelter or transitional program
Currently renting but need to relocate
Other
Primary Source of Income *
Primary Source of Income *
*
Employment
Social Security / Disability
Pension
Other / None
Urgency of Housing Need *
Urgency of Housing Need *
*
Immediate (within 30 days)
Soon (within 60-90 days)
Planning ahead (90+ days)
4 Referral & How You Heard About Us
Referring Agency or Organization (if any)
Caseworker / Social Worker Name (if applicable)
How did you hear about Home Alast Residential?
Community organization
211 Texas
Word of mouth
Social media
Search engine
Other
5 Acknowledgment & Signature
Please Note
Submitting this form adds you to the Home Alast Residential co-living housing waitlist. It does not guarantee placement. A full application and screening process will be completed once a matching home becomes available. Our team will contact you at the phone number or email provided above.
Applicant Signature
Date
-
Month
-
Day
Year
Date
Printed Name *
*
FOR OFFICE USE ONLY
Received by:
Date Added to Waitlist:
Waitlist ID:
Follow-Up Contact Date:
Notes:
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