The City of Houston is creating a new campaign to showcase Houstonians, both renters and homeowners, in their homes and promote housing affordability.  Please complete this form if you are interested in sharing your story to support this campaign. 

If selected, volunteers and other members in their household will be interviewed, photographed and videoed inside and outside their homes.  Selected volunteers will receive free, high quality, professional family digital photos.

By completing this form, I consent to having the information used with the goal of selecting a diverse and representative population to feature in future marketing efforts. The information may be used for quality improvement and/or research purposes.

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* 1. Where do you live?

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* 2. Currently, do you….

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* 5. What religion(s), if any, are practiced in your home?

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* 6. Does anyone speak a language other than English in your home?

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* 7. Does anyone in your home have an intellectual, developmental, or physical disability?

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* 8. Does anyone in your home identify as LGBTQ+?

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* 9. What is your annual household income?

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* 10. Have you received assistance through any of the following?

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* 11. In a couple sentences, tell us about your home.

Here are some questions to help guide you: What is your housing story?  What makes your house a home?  What makes your home or living situation special or unique?

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* 12. Is there anything else you would like us to know?

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* 13. Please enter your contact information.

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* 14. Please select the following that apply.

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