I&R CARES | Supportive Transitional & Veteran Housing

Step 1: Applicant Profile Information

Provide legal identification details and communication channel preferences.

Full Legal Name *

Preferred Name (if different)

Date of Birth *

Phone Number *

Email Address *

Social Security Number (SSN)

Preferred Method of Contact *

Current Address (if homeless, note shelter name or city) *

Provide preferences for accommodations and state income information.

Housing Arrangement Preference *

Desired Move-in urgency *

Preferred Move-In Date

Current Living Situation *

Reason seeking new housing

Current Source(s) of Income (Check all that apply) *

Employment Social Security Disability Benefits Veterans Benefits Retirement/Pension Other Source

Monthly Income Amount ($) *

Can you provide proof of income? *

Yes No