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Public Housing Application Form Template

Simplify Your Public Housing Application Process Today

Navigating the complexities of public housing applications can be overwhelming. This template is designed to help you streamline the application process, making it easier for low-income families to access affordable housing. With this user-friendly form, you can collect essential information, track applications efficiently, and ensure compliance with housing regulations, all while providing a stress-free experience for your applicants. Plus, the form's WCAG-aligned labels enhance accessibility for everyone. Try out the live template and simplify your housing application today.

Use this Template (FREE) Live Preview
Applicant full legal name
Date of birth
Email address
Phone number
Preferred contact method
Phone call
Text message
Email
Mail
No preference
Current residential address
Citizenship or residency status
Citizen
Permanent resident
Refugee or asylee
Eligible noncitizen
Not a citizen or eligible noncitizen
Not sure
Prefer not to say
Total number of people in your household, including you
List household members (name, relationship to you, date of birth)
Are there dependents under 18 in your household?
Yes
No
Is any household member a veteran or active duty?
Yes
No
Please describe any accessibility or accommodation needs
Does anyone in the household have a disability or need accessibility accommodations?
Yes
No
Primary employment status
Employed full-time
Employed part-time
Self-employed
Unemployed
Student
Retired
Unable to work
Prefer not to say
Other
Please Specify:
Monthly household gross income before taxes
No income
$1 - $999
$1,000 - $1,999
$2,000 - $2,999
$3,000 - $3,999
$4,000 - $4,999
$5,000 or more
Prefer not to say
Income sources (select all that apply)
Please Specify:
If applicable, specify any current housing assistance program or voucher
Are you currently receiving housing assistance or a housing voucher?
Yes
No
Current living situation
Renting with a lease
Renting without a lease
Staying with friends or family
Homeless or in shelter
Transitional housing
Temporary hotel or motel
Own home
Institutional setting (e.g., hospital, treatment, correctional)
Other
Please Specify:
Monthly housing cost (rent or mortgage) in your local currency
Are you at risk of losing your housing in the next 60 days?
Yes
No
Have you been evicted in the past 3 years?
Yes
No
Prefer not to say
Do you currently have a lease or occupancy agreement?
Yes
No
Preferred unit size
Studio
1 bedroom
2 bedrooms
3 bedrooms
4+ bedrooms
No preference
Preferred neighborhoods or areas
Accessibility features required (select all that apply)
Please Specify:
Do you have a service or assistance animal?
Yes
No
Do you have a valid government-issued photo ID?
Yes
No
Are you willing to provide documentation to verify income, household size, and residency if requested?
Yes
No
Do you authorize the housing provider to contact current or previous housing providers for verification?
Yes
No
Emergency contact full name
Relationship to you
Emergency contact phone number
Age group
Under 18
18-24
25-34
35-44
45-54
55-64
65+
Gender identity
Woman
Man
Non-binary
Prefer to self-describe
Prefer not to say
If you prefer to self-describe your gender, please specify
Race or ethnicity (select all that apply)
Primary language
Please Specify:
Do you need an interpreter for communications?
Yes
No
I certify that the information provided is true and complete to the best of my knowledge
Yes
No
Typed full name as signature
Signature date
I consent to the collection and use of my information to determine eligibility for housing
Yes
No
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Paper art illustration featuring a public housing application form template with various fields and sections.

When to use this form

Use this template when you need to collect complete, compliant details from people seeking income-restricted housing. This housing application form suits housing authorities, nonprofit providers, and case managers managing waitlists, new openings, or emergency relocations. You can capture household size, income, residency, rental history, and accessibility needs in one secure place. For faster verification, ask applicants to attach proof through a Residence verification form. The result: fewer incomplete applications, clearer eligibility decisions, and smoother move-ins. Applicants get a fair review, while your team saves time on back-and-forth and manual data entry.

Must Ask Public Housing Application Questions

  1. What is your household size and composition, including ages and relationships?

    This determines the right unit size and helps you follow occupancy rules and local priorities. It also supports fair allocation for families, seniors, or single applicants.

  2. What is your total gross monthly income and sources for all household members?

    Income data sets eligibility and rent calculations under program rules. Listing each job, benefit, or support upfront reduces back-and-forth and speeds review.

  3. What is your current address and how long have you lived there?

    Current residency can affect preference points and confirms stability. If needed, you can verify details with a Residence verification form.

  4. What is your rental history and landlord contact information for the past three to five years?

    References and payment history help assess risk and confirm tenancy. You can request proof using a Rent certificate form.

  5. Do you have any accessibility needs or location preferences (e.g., ground-floor unit, elevator, transit access)?

    This helps match you with a suitable, safe unit and comply with reasonable accommodation laws. For broader community input later, you can run a Housing survey form.

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