Housing Application

Housing Application 2017-11-02T07:46:12+00:00

Pre-Application For Housing Waitlist

847 NE 19th Ave Portland, OR 97232 Ph: 503-238-0769 Fax: 503-954-3795

Contact Information:

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Apartment Preferences Requested (Check All that apply)

Please check any / all of the below that apply to your household:

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List each person (starting with yourself) who will occupy the apartment

Name (Last, First, Middle) Date of Birth Relationship to Head of Household Estimated Annual Income Full time or Part time student Y/N

Please include all former, alias and nicknames used and up to 4 people

This Pre-Application is only to establish your place on the waitlist. Once your name comes up on the list it will be necessary to process a full application, run a background screening on all household members 18 years or older and verify all the information necessary to determine your household eligibility for tenancy.

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Please type your First and Last Name

TERMS OF ACCEPTANCE and SIGNATURE

I understand for this housing pre- application the information provided in this application is true and correct to the best of my knowledge.