SRO Housing Questionnaire

All information will be verified.

Please note: you only need to complete this form one time.

* 1. First and Last Name

* 2. Have you ever applied to any SOME Housing Before?

* 3. Do you currently have income?

* 4. If you work, have you been on your job for 3 months or will be by interview date?

* 5. If you have a history of drug or alcohol abuse, do you have 6 months documented clean time that you can produce at time of interview?

* 6. Are you a lifetime registered sex offender?

* 7. Have you committed acts of violence in the last 12 months?

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