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Rental Pre-Application for Housing

Housing Waitlist Pre-Application

Head of household information

Name
Mailing Address

Additional Adult Information

Name

Household Size

Including yourself
Preferred number of bedrooms
(note: minimum 1 person per bedroom, maximum 2 people per bedroom):
Preferred housing units to be considered for:
(Check all that apply)
Does anyone in your household have a disability?
Are you currently on a Federally Subsidized Housing Waitlist?
Does anyone in your household require an Accessible unit? (Wheelchair, visual assistance, etc.)
Are you currently homeless?
Has anyone in your household been charged with a felony?
Have you ever been evicted

Sources of Family Income

*Use approximate values*
Demographics (for HUD statistical purposes only)
Check all that apply
Ethnicity
Please identify your ethnicity by checking one box.
Gender
Check all that apply
Electronic Communication Consent
By submitting this form, you consent to receive all correspondence related to your pre-waitlist submission electronically. This may include notices, requests for information, updates, and other communications sent by email or other electronic means using the contact information you provide. You understand that paper correspondence will not be sent. You are responsible for ensuring your contact information remains accurate and accessible. You may withdraw this consent at any time by contacting us, understanding that withdrawal may affect our ability to communicate with you regarding your pre-waitlist status.

Statement and Signature:

I certify that the above information is accurate and complete and that submitting false information could result in the removal from the list. By signing below, I acknowledge that I have read the attached welcome letter and I understand my obligations as an applicant on the FNHS housing waitlist.

Clear Signature

1427 Gillam Way, Fairbanks AK, 99701

Phone (907) 451-7230

Fax (907) 451-7236

Email properties@fnhs.org