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Meet the Team
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GCS - Housing Application
Date of Birth
Are you currently homeless?
Referral Source. How/Where did you hear about us?
What city would you prefer to live in?
What allergies do you have?
Requested move in date
Driver's License #
Payment Source. How will you be paying your rent?
Paycheck from employment
Voucher (Fostering Futures, etc.)
Do you have a payee?
If your payment source is from employment, please list the name of your employer.
Amount of Payment Source? Type the amount received monthly or bi-weekly.
Do you have criminal legal concerns - felony, misdemeanor, on probation, etc.?
Are you a smoker?
Do you have any medical diagnosis/concerns? If yes, please list them.
Do you have any behavioral/ mental health needs that we should be aware of? Please be honest, we are here to help, but need to be adequately prepared, as well
Do you have a child/children?
Do you have a case manager/social worker/agency you already work with? Type Yes or No. If yes, please list their name and contact information below.
Social Security Number
Do you have a driver's license?
If yes, what is your ID#
Do you own a car?
Are you in need of transportation?
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