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Apply for Housing Assistance

Thank you for your interest in Rise Point Living. Please complete the application form below and a member of our team will review your information and contact you regarding the next steps.

Application Form

First Name

Last Name

Date Of Birth

Dropdown

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Preferred Contact Method

Current Housing Situation

Estimated Monthly Income ($)

Desired Move-In Date

Do You Have Pets?

Yes

Do You Have Special Accommodation Needs?

Number Of Occupants

Emergency Contact

Emergency Contact Number

Employment Status

Have you ever had an eviction filed against you?

Yes

Type Of Assistance Needed

Tell Us About Your Housing Needs

Are You Currently working With An Agency

Agency Name (If Yes)

Referral Source

Please Specify Other Referral Source

Enter Case Manager Name (If Applicable)

Case Manager Phone Number If Applicable)

Case Manager Email

Applicant Certification

I Certify that the information provided is true and complete to the best of my knowledge.

Authorization to Verify Information

I Authorize Rise Point Living to verify the information provided as part of the application review process

Communication Consent

I consent to being contacted regarding housing availability and application updates

Applications are reviewed in the order received.

Completing this application form does not guarantee housing placement.

We are committed to reviewing all applications with compassion, respect, and confidentiality.