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UEAAH Registration/Intake Form
Thank you for registering and completing UEAAH's intake. We will keep your information and contact you via email with information regarding our:

*BAH petition
* Events and fundraising campaigns
* Housing opportunities
*K-12 teacher housing policies changes
*And much more.

We will not give out any of your information. Information will only be used as statistical data for UEAAH, revealing no individual information to anyone.
Full Name (First and Last): *
Your answer
Email: *
Your answer
Telephone Number: *
Your answer
Are you a K-12 public school teacher *
Required
If yes, what is the name of your school district you teach in? (Type N/A if not applicable) *
Your answer
What kind of Teaching Credential have you earned (K-12 Public School Teachers Only)?
What is your salary range annually (K-12 Public School Teachers Only)? *
Education Level (K-12 Public School Teachers Only)
What is you marital status? *
Do you have dependents (children/aging parents and/or relatives you are caring for)? *
Do you support the idea of having a federally funded Basic Allowance for Housing (BAH) to support all K-12 public school teachers with housing? *
Are you open to speaking to media in the event that we need to hear from a teacher or supporter of our mission? *
What is your housing preference? *
Which of the following best describes your current living situation? *
Please type in the name of the State and City which you are living in. *
Your answer
Would you like us to contact you if and when housing becomes available in your area? *
If you have an estimate, please list the maximum rent price you are able to pay per month on your housing.
Your answer
How many other people will be living with you? *
Your answer
How urgent is your search for housing currently? *
Anything else you would like us to know about your housing needs?
Feel free to give us any details regarding what type of place, or location, you are looking for.
Your answer
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