Basic Information

Please provide your basic personal information to begin the application process.

Client Information

Client's Name - First Name *

Last Name *

Email

Client's Gender *

Client's Phone Number *

Please enter a valid phone number.

Do we have permission to text/leave a message on the number provided? *

Date of Birth *

Current Address

Street Address

City *

State *

Referral Information (Optional)

Who referred you?

I have a referral source assisting with this application

Income and Benefits

Help us understand your financial situation and how you plan to pay for housing.

Financial Information

Do you have a steady source of income? *

Yes No

What is your monthly income? *

Do you receive Food Stamps / EBT (SNAP benefits)? *

Yes No

Is an agency/organization providing funding?

Yes, an agency/organization is providing funding

Independent Living Ability

Tell us about your health, medical needs, and ability to live independently.

Health & Disability Information

Housing Preferences and Needs

Share your housing preferences and timeline.

Housing Preferences

What type of room are you looking for? *

Shared Room Private Room No Preference

Do you understand this is a shared independent living program and you will have a roommate? *

Yes No

Do you have any physical disabilities or mobility concerns? *

Yes No

Background Screening

We need some background information for our records.

Background Information

As part of our screening process, we may conduct background checks to ensure the safety and wellbeing of all residents. This information helps us create a supportive and secure living environment for everyone.

Have you ever been convicted of a crime? *

Yes No

Have you ever been evicted from housing? *

Yes No

Are you a registered sex offender? *

Yes No

I understand and consent to ThrivHive conducting a background check as part of the application process. *

Lifestyle and House Rules

Help us understand your lifestyle preferences and willingness to follow community guidelines.

Are you willing to follow house rules (e.g., no drugs, no unapproved guests, quiet hours, cleanliness)? *

Yes No

Do you smoke? *

Yes No

Do you have any pets? *

Yes No

Final Notes

Help us better understand your situation and any additional information.

Why are you seeking housing at this time? *

Is there anything else you would like us to know?

Waitlist Application

Basic Information

Client Information

Current Address

Referral Information (Optional)

Income and Benefits

Financial Information

Is an agency/organization providing funding?

Independent Living Ability

Health & Disability Information

Housing Preferences and Needs

Housing Preferences

Background Screening

Background Information

Lifestyle and House Rules

Final Notes