This intake sheet is used to better understand your housing needs and how DRDz can assist. Our Housing Coaches will use this information to design a C.H.P-College Housing Plan that best fits your individual needs.
Do you have children?
Do you have a pet?
Are you employed?
What college do you or will you attend?
College Classification (Yr in College)
Current living situation? where did you sleep last night
Renting a home
Renting a room
Living with family/friend
Own your home
On campus housing
off campus student housing
Have you been evicted in the last 12 months?
Describe your housing situation and why you feel you need assistance
What is your long term housing goal
TYPE OF HOUSING NEEDS:
Rental Assistance- behind in rental payment Amount past due?_______
Rapid Re-Housing- recently lost housing and finding a new place need assist with deposit and/or rent
Supportive Housing- case manager and additional services
Affordable Housing- need to find something you can afford
Section 8- income base Housing
Roommate match-looking for someone to share the rent
Private Student housing- off campus housing designed for college students
Companionship- light house cleaning and meals in exchange for free room and baord
Please provide any additional information you would like to share.
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