Application for Interview & Placement Consideration

Completion of this application does not guarantee housing placement.

Applications are used to determine eligibility for interview and shared housing consideration.

Qualified applicants will be contacted to schedule an interview.

SECTION 2: HOUSING READINESS

Are you applying for yourself or on behalf of someone else?

For myself

For a client / individual support

👉 If on behalf of someone else what is YOUR name / Organization / Agency (if applicable) or relationship to client:

Are you able to participate in an interview (in person or virtual) within the next week?

Yes

What city do you need housing ?

Tuscaloosa

Birmingham

Either Tuscaloosa or Birmingham

What type lodging are your seeking ?

Semi - Private

Private

Do you have income ?

YES

Are you able to move into shared housing by or around the 1st?

Yes

Possibility

When do you need housing ?

ASAP

Within 1-2 weeks

Within 30 days

Just getting information

What is your current situation ?

SECTION 3: SHARED HOUSING UNDERSTANDING

Serenity Bridges offers shared bedrooms and shared common areas. Are you comfortable with shared living?

Yes

Are you able to respect house rules, quiet hours, and shared space expectations?

Yes

Do you understand that this is a structured housing environment, not independent apartment living?

Yes

SECTION 4: INDEPENDENCE & SUPPORT

Are you able to independently manage daily living tasks (personal hygiene, medication reminders, basic routines)?

Yes

Do you currently receive case management or support services?

Yes

If yes: Agency / Provider Name - Case Manager Name & Contact (if available)

SECTION 5: FINANCIAL & PROGRAM FIT

Will housing costs be

Self - pay

Agency - assisted

Program - funded

Combination

Are you able to discuss housing fees and expectations during the interview process?

Yes

SECTION 6: INTERVIEW CONSIDERATION

How may we best accommodate you?

Best way to contact you ?

Do you have a case manager , social worker or parole officer ? if so list name and contact info here .

SECTION 7: ACKNOWLEDGMENT

Please check all that apply: *

I understand this application is for interview and placement consideration only

I understand housing placement is not guaranteed

I understand Serenity Bridges is a shared housing community

I agree to be contacted regarding next steps

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