Housing Application | Home Works USA

Pre-Qualification Questionnaire

Is the Home Works USA Community a good fit for you? Please respond to the questions below to help us get to know you better.

First name

Last name

Phone

Have you spent time in foster car?

Yes

No

Are you between the ages of 18 and 26 years old?

Yes

No

What category best describes your current ability to spend between $500 and $600 a month on housing expenses, including rent and utilities?

My resources would not allow me to spend that amount on housing every month.

If I spent that much on housing, I would have trouble affording necessities such as food, clothing, transportation, and medical care.

If I spent that much on housing, I would still be able to afford necessities as long as nothing unexpected happens.

I would be able to spend more than that on housing and have no trouble affording necessities.

Other (please describe)

What best describes your current living arrangements?

I will be 18 soon and am looking at my options.

I need to move within the next month.

Other (please explain)

Have you seen a video of the houses?

Yes

No

Link to YouTube Reels

What size unit are you interested in renting? View video above.

256 sq ft (roughly the size of 1 car garage)

384 sq ft (roughly the size of a small studio apt)

Do you require an ADA (Americans with Disabilities Act) compliant unit?

Yes

No

Do you understand that these units are single occupancy and that there are restrictions on overnight guests included in the lease?

Yes

No

Do you understand that you may not sublet your home?

Yes

No

Do you understand that these homes do not have garbage disposals, dishwashers, or laundry facilities?

Yes

No

Have you ever lived in a place with a septic system because that is what we have at 26050 Chieftain Rd? Septic systems require extra care, especially with what is flushed or put down drains.

Yes

No

Do you use tobacco?

Yes

No

Do you understand that this is a Tobacco Free Community?

Yes

No

What do you think you would like about living in a rural community?

Plans in Action

Do you have a reliable/ dependable resource from which to pay your rent when due?

Yes

No

What is your ability and intent to pay your rent?

Living Well with the Environment in Mind

Are you willing to participate in, design, and improve programs that have a goal of zero waste in this community?

Yes

No

Maybe

I'm not familiar with zero waste, but I'd like to learn more.

Are you ready to participate in curbside composting?

Yes

No

Maybe

I'm not familiar with curbside composting, but I'd like to learn more.

Are you familiar with net metering and how to conserve electricity?

Yes

No

Would you help grow food for the community to increase food security and lower food costs?

Yes

No

Maybe

Getting from Here to There

Do you plan to have an automobile on premises?

Yes

No

Maybe

Do you plan to have a bike or ebike on premises?

Yes

No

Maybe

Share Your Story

What else would you like to tell us about yourself and how living in the Home Works USA Community will help you achieve your personal goals?

I prefer you contact me by email, text, or phone call. I will update my contact information if it changes.

Thank you for your interest in the Home Works USA Community. Your responses will be reviewed and you will be contacted for next steps.