Host Application RM_StatsYour InformationLegal Name *Other names usedMailing Address State or Region United States Canada Physical Address (if different) State or Region United States Canada Email *Home PhoneCell PhoneWork PhoneBest number to call during the daySelect an optionHomeCellWorkHousing HistoryCurrent housing situation. If other, please explainSelect an optionRentOwnOtherExplanation of current housing situationHow long at current address?What pets do you have?If you own a dog, has it ever bitten anyone?Select an optionYesNoRent & ServiceHow much rent per month would you charge?How many hours of service per week do you need?We ask for the following information to help determine that RappHomeShares does not discriminate in its services.GenderDate of BirthAgeEthnicitySelect an optionHispanicNot HispanicRace (check all that apply) White Black/African American Asian American Indian/Alaskan Native Native Hawaiian/Other Pacific Islander Multiracial Other Number of people in householdReferencesAll references should be people who have known you at least 1 year. Together, the references should cover a span of at least 5 years to the present. We require references from past or present roommates, employers, or co-workers. NOT ACCEPTED as references are family members, friends, or romantic partners. Tell your references that Rapp HomeShare will be calling them. If you have trouble reaching them, we will have the same trouble, and your application will be delayed.Reference 1Daytime phoneCityStateEmailHow long have they known you?How do they know you?Reference 2Daytime phoneCityStateEmailHow long have they known you?How do they know you?Reference 3Daytime phoneCityStateEmailHow long have they known you?How do they know you?Reference 4Daytime phoneCityStateEmailHow long have they known you?How do they know you?Other information you want us to knowIs there another adult in the house with you?Select an optionYesNoAcknowledgment *I hereby acknowledge that all the information I have given in this application is true and complete to the best of my knowledge and belief. I understand that providing any false or misleading information will make me ineligible for the services of RappHomeShares.I agreeSigned * Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
