Unity House Shared Living - Room Rental Application Form
Thank you for your interest in renting a private room in one of our professionally managed shared homes. Please complete this short form to help us determine your eligibility.  We will verify all information you submit to us.  If you lie or withhold any information, your application will be denied.  If we find out after you move in that you lied or withheld information on any of the information you provide to us now, or at any time, you may be told to leave!  
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Full name *
Date of Birth *
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Phone number *
How many people in total (including children) will be living with you?  (Our housing is suited for single adults) *
How long have you lived in Wisconsin? *
List ALL states and countries you have lived in in the last 10 years besides Wisconsin.  Write NA if you have only lived in Wisconsin in the last 10 years.   *
Ok to text? *
Email address *
Current Address (if applicable)
Your Social Security Number *
Are you currently renting?  If yes, for how long? *
If you are currently renting, please provide your address and contact information for your current landlord/manager.
Desired move in date *
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Where did you hear about us from? *
What is your current employment status? *
Where do you work, and what do you do? *
What is your approximate monthly income? *
How long do you plan to stay with us?  *
Why are you moving? *
Where do you see yourself in 6 months from now?  Briefly describe what you want your life to look like then? *
Where do you see yourself in 1 year from now?  Briefly describe what your life looks like in 1 year from today  *
Have you been evicted from anywhere within the last 10 years?  If yes, how many times, and why?  Be specific, give dates, and details for each occurrence.  We will verify.   *
Are you working with a social or caseworker?  If yes, please provide their full name, name of their organization,  and their direct contact information.  *
Do you have any criminal history?  If yes, please describe in detail, and be specific. *
Do you currently have a parole or probation officer?  If yes, we will need their full name, and direct contact information. *
Can you pay the first month's rent and the one time non-refundable community fee of $350 (instead of a security deposit) upon move-in? *
What are you looking for in a shared living environment?  Be as specific as you can. *
Please describe how you handle disagreements with house mates?  Be specific. *
What does it mean to you to live respectfully with others?  Be specific. *
Have you ever had to follow house rules before?  What worked and what didn't work?  Be as specific as you can. *
What does cleanliness mean to you on a daily basis?  Be specific. *
Have  you ever been asked to leave housing before due to a behavior or safety concern? *
If yes, please describe. And be specific. 
Do you have any regular guests or people who would be staying overnight?   *
Do you have any animals/pets who would be living with you?   *
Is there anything you'd like us to know about your living habits or lifestyle?  Be as specific as you can if there is anything you want us to know. *
Please provide an emergency contact.  We need their name, relations to you, direct phone number and address if possible.  *
We have a code of conduct that all residents are expected to follow at all times.  We will go over it with you in person, but briefly, you will be required to:

- always pay your rent in full and on time
- live independently, handle your own hygiene, healthcare, meds (if applicable) cleaning, etc. all without assistance or reminders.
- keep all areas of the house clean at all times
- no smoking/vaping indoors
- there are quiet hours you'll have to obey
- respectful communication at all times is a must (even if you're not having a good day.)  Aggressive, unsafe, or disruptive behavior will not be tolerated.

I understand that failure to follow these expectations may result in fines, written warnings, or rapid eviction from housing. We remove residents who violate our rules, regardless of cause.

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