NNHS Guest Application

This field is for validation purposes and should be left unchanged.
Reference Sheet
Name(Required)
Any past association with A1AA?(Required)
Mailing Address(Required)
Physical Address (if different)
Okay to text?(Required)
Best to call(Required)

General Information

Have you ever shared housing? (other than with immediate family)?(Required)
Preferred Location(Required)
Hours of service you can provide
If a dog, has it ever bitten anyone?(Required)
Transportation(Required)
I'm also interested in teaming up with a compatible home seeker to expand my housing search (see page 9)(Required)

Demographic Information

We ask everyone the following demographic questions that are intended to improve care delivery, reduce disparities in access to services and improve measurement and recognition that can lead to more services and funding. You can choose not to answer any question. Your information is kept confidential and is federally protected against intrusion and unlawful sharing.
Ethnicity
Race: (check all that apply)
What pronouns do you use?
Choose the option that best describes you: (check one)
Which of the following best describes you? (check one)
Have you ever served in the United States military?
Are you the spouse, legal partner, parent, or child of a person who is serving in or who has served in the United States military?
Do you have a disability?

Background & Reference Checks

As part of our application process, we perform background and reference checks and conduct a personal interview.
Do you have any motor vehicle violations?(Required)
Do you have any pending criminal charges?(Required)
Have you had any criminal convictions?(Required)
Have you ever been evicted?(Required)

Housing History

Current housing situation(Required)
Previous housing situation(Required)

Employment History

Are you(Required)

Service Information

Which of the following services would you be willing to provide?(Required)

Home Information

What else would you require?(Required)
Shared laundry facilities okay?(Required)
Do you wish to bring your own bed?(Required)
What other furniture will you be bringing?
Would you live with someone who has pets?(Required)
Do you own guns or weapons?(Required)
Are your weapons legally registered?(Required)
Will you live with someone who keeps guns or weapons in their home?(Required)
Do you want cable TV and/or internet service?(Required)
Would you be willing to pay to have it set up if not currently available in the home?(Required)
Would you let your homesharer know about your comings and goings?(Required)
Will you be spending time away? (vacations, weekends, housesitting, etc.?)(Required)
Will you have guests?(Required)
Do you smoke?(Required)
Would you live with a smoker?(Required)
Do you grow cannabis?(Required)
Do you use cannabis products?(Required)
If yes, do you do so at home?
How do you consume cannabis?
Would you live with someone who uses cannabis?(Required)
How often do you drink?(Required)
Would you live with someone who drinks at home?(Required)
How do you identify politically?(Required)
Would you be willing to live with someone who does not share the same socio-political views?(Required)
Would you be willing to live with someone who does not share the same religion?(Required)
Would you be willing to live with someone who does not share the same ethnicity?(Required)
Are you comfortable living someone of another gender?(Required)
Are you comfortable living with someone of different sexual orientations, gender identities, and backgrounds?(Required)
Terms and Conditions(Required)