Housing intake

Tell us what you are looking for.

Choose the path that fits. Your information is used only to prepare and respond to your housing inquiry.

Resident intake & screening

Personal information

Fields marked * are required. Read our Privacy Policy.

First name *Last name *Date of birth *Must be 18 or olderPhone *Email *Best way to reach you *

Current housing situation

Current addressCurrent housing status *Preferred locationWhen do you need to move? *Time at current addressAnything you would like us to know?

Income & ability to pay

Primary income source *Approximate monthly income *Monthly housing budget *Income verifiable? *Deposit and first month’s rent at move-in? *

Fit & acknowledgments

Shared housing experience?Vehicle?Lease preferenceWorking with a case manager? I am 18 years of age or older. I understand bedrooms may be shared and the kitchen, living areas, and laundry are shared. I have read and agree to the house policies. I understand screening and this form do not guarantee a room. I understand a deposit and first month's rent are required before move-in. The information I provided is accurate and truthful. I consent to contact by phone, text, or email.

Graceful Haven complies with the Fair Housing Act. We do not discriminate on the basis of race, color, national origin, religion, sex, familial status, or disability. If you need a reasonable accommodation to apply or live in our homes, let us know and we will work with you.