Comfort Commons Housing Application
Complete this application to be considered for housing placement; submission does not guarantee availability.
Applicant Information
Full Name
*
First Name
Middle Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Preferred Contact Method
*
Please Select
Phone
Email
Text Message
Preferred Move-in Date
-
Month
-
Day
Year
Date
Urgency
Immediate
Within 1 Month
Within 3 Months
Flexible
Current Housing Situation
*
Please Select
Renting
Living with Family/Friends
Temporary Housing
Experiencing Homelessness
Own Home
Other
Desired Housing Type
*
Private
Shared
Household, Income, and Support Information
Household and roommate considerations
Current income and benefits sources
Employment wages
Self-employment
SSI/SSDI
TANF
SNAP
Veterans benefits
Child support
Pension/retirement
Family/friends support
Other
Gross Monthly Income
Current employer or program name
Referral source
Case manager name
First Name
Middle Name
Last Name
Case manager phone
Please enter a valid phone number.
Format: (000) 000-0000.
Accessibility, daily-living, and support needs
Transportation needs
Housing goals and placement preferences
Housing placement considerations and optional support notes
What Happens Next
A brief overview of the next steps after you submit your application.
1. Your application is submitted. 2. Comfort Commons reviews your housing needs, eligibility, funding or payment source, property restrictions, and current availability. 3. You may be contacted if we need more information. 4. If you appear potentially eligible, a tour or interview may be scheduled. 5. We will communicate the final placement decision. 6. If approved, you will move on to Resident Intake & Assessment and complete any required agreements before move-in.
Preferred Interview or Tour Availability
*
Please Select
Weekdays during business hours
Weekday evenings
Weekends
Flexible / any time
Acknowledgment of Next Steps
*
I understand that submitting this application does not guarantee acceptance or a bed, and placement depends on eligibility, availability, payment or funding, property requirements, and safety considerations.
References and Documents
Reference Name
Reference Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference Relationship and How Long They Have Known You
Upload Supporting Documents
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Consent to Verify Information and Acknowledgment of House Rules and Eligibility Requirements
*
I consent to verification of the information provided
I acknowledge and agree to follow the house rules
I understand I must meet the eligibility requirements
Certification
Electronic Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit Application
Submit Application
Should be Empty: