NNHS Host Application

Thanks for your interest in the Northern Nevada HomeShare Program. This application helps us get to know you—your lifestyle, preferences, and what you’re looking for in a shared living arrangement. The more we understand about you, the better we can match you with a Host where everyone feels comfortable and supported.

This field is for validation purposes and should be left unchanged.
Reference Sheet
Applicant Name(Required)

Contact Information

Full Name(Required)
Mailing Address(Required)
Physical Address (if different)
Okay to text?(Required)

Housing Information

Current housing situation(Required)
If dogs, have they ever biten anyone?

General Information

Have you ever shared housing? (other than with immediate family)?(Required)

Rent & Services

Service Information

Do you want a homesharer to help with any of the following? (Check all that apply)

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.
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?(Required)
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)

Employment History

Are you(Required)

Home Information

What would you offer to your homesharer?

Bathroom(Required)
Stair lift(Required)
Laundry facilities(Required)
Furniture
Could a homesharer bring their own furniture?(Required)
Are there guns/other weapons in the house?(Required)
If yes, are your weapons legally registered?
Could a homesharer have legally registered and securely stored guns / weapons?(Required)
Will you offer separate cupboard space for a homesharer’s food?(Required)
Do you have cable TV and/or internet service that you're willing to share?(Required)
What does that include?
If not, could either be added at their expense?
Do you want a homesharer to let you know when they are leaving and expecting to be back?(Required)
When do you have guests?(Required)
Could your homesharer have guests?(Required)
Would you accept someone who has pets?(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, how do you consume cannabis?
Would you live with someone who uses cannabis?(Required)
Would you allow a homesharer to use cannabis at home?(Required)
How often do you drink?(Required)
Would you live with someone who drinks at home?(Required)
If yes, how often?
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 of a different ethnicity?(Required)
Are you comfortable living with someone of a different gender?(Required)
Are you comfortable living with people of different sexual orientations, gender identities, and backgrounds?(Required)
Acknowledgement(Required)