Application for Housemates
If you are interested in finding out more about applying to be a housemate in our affordable housing, please complete this form bellow and you will be contacted by one of our staff members. Residents must be above the age of 21, must be able to pass a background check as well and financial eligibility requirements. 

For more info, go to www.ourplacenashville.org
Sign in to Google to save your progress. Learn more
Applicant's Complete Name *
Applicants Date of Birth *
MM
/
DD
/
YYYY
Which of these categories best fits your situation *
Applicant's Place of employment (If applicable)
Do you have a diagnosed intellectual or developmental disability? 
Clear selection
Do you have any physical disabilities or medical needs?
Clear selection
Our housing is Affordable Housing as defined by the Federal Government. This means that all residents must go through a financial qualification to ensure that they qualify for affordable housing. How much income do you earn? (including any SSI, SSDI, living stipends, etc)
Clear selection
Applicants Email Address *
Cell Phone Number *
What is your desired date or month of move?
How did you hear about Our Place Nashville? 
Other Questions or Comments
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms