Waitlist Application - Abilene Terrace
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Preliminary Application for Abilene Terrace
Please note: this is only a preliminary application that will be used to place your name on the property above's WAITING LIST. Once your name comes to the top of the waiting list, we will contact you regarding the next step in the application process. You can expect to receive a letter from us acknowledging receipt of your preliminary application and a preliminary determination of your eligibility.
Applicant Name
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First
Last
Applicant Phone
*
Date of Application
MM slash DD slash YYYY
Applicant Email
*
Enter Email
Confirm Email
Current Address
*
Street Address
Address Line 2
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ZIP Code
Move-in Requested Date
*
MM slash DD slash YYYY
Number of Bedrooms Wanted
*
2
Applicant Information
Applicant Name
First
Last
Applicant Age
Applicant Birth Date
MM slash DD slash YYYY
Applicant Gross Monthly Income
Applicant Income Source
Applicant is disabled?
*
Yes
No
Applicant is a veteran?
*
Yes
No
Applicant is a US Citizen or Eligible Non-citizen?
*
Yes
No
Applicant Social Security Number
Applicant Ethnicity/Race
*Filling this area out is optional* This information is collected to assure compliance with Fair Housing & Equal Opportunity Rules
Applicant Ethnicity
Hispanic or Latino
Not Hispanic or Latino
Applicant Race
White
Black
Native American/Alaskan Native
Asian/Pacific Islander
Additional Occupant Information
List ALL additional individuals who will be living with Applicant.
(Use the + button on the right-hand side to add additional occupants)
*
(Use the + button on the right-hand side to add additional occupants)
Full Name
Relationship
Birthdate
SSN
Gross Monthly Income
Source of Income
Add
Remove
Referrals and Signatures
If an individual or another agency referred you to Mennonite Housing, please list them below
Applicant's Signature
*
In signing this application, I certify that all the statements made on this application are true and complete to the best of my knowledge. I understand that false or incomplete information may result in denial of housing assistance. I certify that no member of the household or any guest engages, or will engage in violent or drug-related criminal activity.
Email
This field is for validation purposes and should be left unchanged.