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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.
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Full Name (First and Last): *
Email: *
Telephone Number: *
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) *
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)
Clear selection
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. *
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.
How many other people will be living with you? *
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.
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