Waiting List Application
Full Name of Applicant *
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Address *
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Primary Phone Number *
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Secondary Phone Number *
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Family/Friend/Case Manager Contact (OPTIONAL: helpful to Rush Homes during waiting list updates)
Your answer
Family/Friend/Case Manager Phone Number
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Relationship
Address of Family/Friend/Case Manager
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Should we contact this person
Does the applicant have a disability? *
Need Wheelchair Accessibility? *
Does the applicant receive SSI/SSDI? *
Family Size *
Your answer
Number of Bedrooms needed: *
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Location Preference *
Need Bus Line? *
Have a Housing Choice Voucher? *
How did you hear about Rush Homes? *
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