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Family Housing Pre-Application

PRE-APPLICATION (Family Housing)

CHOOSE A LOCATION:
TYPE OF RENT OPTIONS:
I have a Housing Choice Voucher.
I am applying for the Income Based (Subsidized) Program.
I am applying for a Market Rent Unit (Regular Renting).
BEDROOM CHOICE:
1 Handicapped Bedroom
2 Handicapped Bedroom
2 Bedroom
3 Bedroom
4 Bedroom

HEAD OF HOUSEHOLD NAME: (required)

Date of Birth
Month
Day
Year
Sex
Male
Female
Choose Proof of Identification
Driver's License
State I.D.
Other

CURRENT ADDRESS: (required)

Multi-line address
Please list any STATES where you have previously lived:
Source of Income:
Check One:
Weekly
Bi-Weekly
Monthly
Yearly
Are you currently living in subsidized housing?
Are you required to give a 30-day vacancy notice?
Yes
No
Are you a full-time student?
Yes
No

CO-HEAD OF HOUSEHOLD:

Date of Birth
Month
Day
Year
Sex
Male
Female
Choose Proof of Identification
Driver's License
State I.D.
Other

CURRENT ADDRESS: (required)

Multi-line address
Please list any STATES where you have previously lived:
Source of Income:
Check One:
Weekly
Bi-Weekly
Monthly
Yearly
Are you currently living in subsidized housing?
Are you required to give a 30-day vacancy notice?
Yes
No
Are you a full-time student?
Yes
No

ANY OTHER HOUSEHOLD MEMBER OVER 18:

Date of Birth
Month
Day
Year
Sex
Male
Female
Choose Proof of Identification
Driver's License
State I.D.
Other

CURRENT ADDRESS: (required)

Multi-line address
Please list any STATES where you have previously lived:
Source of Income:
Check One:
Weekly
Bi-Weekly
Monthly
Yearly
Are you currently living in subsidized housing?
Are you required to give a 30-day vacancy notice?
Yes
No
Are you a full-time student?
Yes
No
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