Booking a Stay at Ma Bailey's

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We are looking forward to serving you with quiet and rest during your stay.
Please contact us if you have any questions. We are available 24/7 during your stay, should any needs arise.
All other inquires and questions, we ask to be between 8am-6pm Monday-Saturday

Email *

First Name *

Last Name *

Phone Number *

Mailing Address *

Emergency Contact Person *

Emergency Contact Phone Number *

Please select one: I am a... *

Provider

New Mother/Family

Expecting Mother/Family

Other:

Please select which unit you would prefer to stay in: *

Homestead Unit

Sage Unit

Spruce Unit

Lively Unit

Expected Arrive Date: *

YYYY

Expected Arrive Time: *

Time

Expected Departure Date: *

YYYY

Expected Departure Time:
(adjustments to your expected times are welcome based on unit availability) *

Time

Anything else you feel you'd like us to know? *

Demographics questions for nonprofit use only.

This helps us better understand who we are helping, and to apply for funding!

Age: *

Gender: *

Female

Male

Prefer not to say

Other:

Ethnicity: *

A. White/Caucasian

B. Asian

C. Native Hawaiian or Pacific Islander

D. Hispanic or Latino

E. African-American

F. Native American

G. Two or more

H. Other (please specify)

I. Unknown

J. Prefer not to say

Other:

Education: *

A. Less than High School

B. High school (including GED)

C. Some college (no degree)

D. Technical certification

E. Associate degree (2-year)

F. Bachelor’s degree (4-year)

G. Master’s degree

H. Doctoral degree

I. Professional degree (JD, MD)

J. Prefer not to say

Other:

Marital Status: *

A. Married

B. Widowed

C. Divorced

D. Separated

E. Single

F. Prefer not to say

Other:

Employment: *

A. Full-time

B. Part-time

C. Contract or temporary

D. Retired

E. Unemployed

F. Unable to work

G. Other (please specify)

H. Prefer not to say

Other:

Household Income: *

A. $0-$29,999

B. $30,000-$59,999

C. $60,000-$89,999

D. $90,000-$119,999

E. $120,000+

F. Prefer not to say

Other:

Rules and Regulations
(The submission of this form indicates your agreement with all Rules and Regulations listed)

HOUSE RULES:

Quiet times: 10p-6a
No drug or alcohol use
Respectful of other tenants privacy and needs
Visitors- Limited to 2 visitors over 18 years of age.
Children limited to 3 per unit including tenants and visitors
3 vehicles per unit if capacity allows
Please respect our place and report any damages or concerns.
Tenants are asked to comply with any other limitations the property manager sets in place when deemed needed.
Inspection/safety check with minimum 2 hours notice

For concerns or questions, please contact Ruth Bailey at 512-468-1576

Would you like to support Ma Bailey's to others for $5-$50 (or more if you feel led!) per month?

You can make a ONE TIME donation here OR a MONTHLY SPONSORSHIP by following this link:

Ma Bailey's Support Fund

We operate solely on donations from the community. If you or if you know of someone who can contribute just a few dollars a month, we can make the world a better place for new families.

A copy of your responses will be emailed to the address you provided.

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