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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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* Required
Full Name (First and Last):
*
Your answer
Email:
*
Your answer
Telephone Number:
*
Your answer
Are you a K-12 public school teacher
*
Yes
No
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)?
Single Subject
Multiple Subject
Special Education
Designated Subject (Adult Education, Career Technical Education, or Business and Industry Partnership)
Other Teaching Credential (American Indian Language, Exchange Certificated Employee, Sojourn Certificated, or Eminence)
What is your salary range annually (K-12 Public School Teachers Only)?
*
0-$45,000
$46,000-$65,000
$66,000-$75,000
$76,000-$85,000
$86,000-$95,000
$96,000 and up
Not a teacher
Education Level (K-12 Public School Teachers Only)
Bachelors
Masters
PHD
Not a teacher
Clear selection
What is you marital status?
*
Single
Married
Domestic Partnership
Do you have dependents (children/aging parents and/or relatives you are caring for)?
*
Yes
No
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?
*
Yes
No
Maybe
Are you open to speaking to media in the event that we need to hear from a teacher or supporter of our mission?
*
Yes
No
Maybe
What is your housing preference?
*
Buying a home/Ownership
Renting a house or apartment
Room Sharing
Teacher Designated Housing
ADU (accessory dwelling unit)
Which of the following best describes your current living situation?
*
Homeless
Staying with family or relative
Renting Apartment Alone
Renting Apartment with others
Renting Home Alone
Renting Home with others
Living in car or shelter
Staying with friend
Living in teacher housing
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?
*
Yes
No
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?
*
Need a place to stay within upcoming few days or weeks
~1-3 months to find a place
~3-6 months to find a place
~6 months -long term to find a place
Looking to move soon, but not urgent.
Not sure.
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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