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Quick-Screen Questionnaire
30% RTI
$
40% RTI
$
50% RTI
$
First Name
*
Last Name
Phone
*
Email
*
Do you have a specific rental in mind?
*
Rental address
How will your rent be paid?
*
How many bedrooms are you looking for?
*
Are you looking for a house only, or would you consider an apartment as well?
*
Which housing program will be assisting with your rent?
How much of your rent are you responsible for paying out of pocket each month (not the full rent)?
For most subsidy programs, the tenant portion is usually around 30% of your gross monthly income, not the total contract rent.
What is your gross monthly income?
$
What is your source(s) of income?
*
Select more than one if applicable.
What is your maximum monthly rent budget?
$
How will the security deposit be paid?
*
How much will you be able to pay toward the security deposit at lease signing?
$
Employer or Employed by
Job title
Years on job
Enter the number of full years with your current employer. If less than one year, select 0. Additional months will be collected in the next question.
Additional months on job (0–11)
What was that job title?
Who was the employer?
How many adults will be living in the household?
*
How many children or dependents will be living in the household?
*
Do you have pets?
*
Are you working with a Case Manager?
*
Case Manager name
Case Manager mobile
Case Manager email
Subsidy, voucher upload
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