General Housing Application:

If you'd like to print a copy of the application, click here. You can drop off the application at any office or by faxing it to 812-331-7990.

About Me:

*First Name:

Middle Name:*Last Name:

Phone (cell):

Phone (other):

*Primary Email:

Secondary Email:

Is it OK for us to text you?

Yes No

Which is your preferred method for us to contact you? (choose all that apply)

Cell Phone

Other Phone

Primary email address

Secondary email address

T ext message

Current address:

City:

State: Zipcode:

Permanent address:

City:

State: Zipcode:

*DOB:

Emergency Contact:

Name:

Relationship: Phone:

List of people living with you

First name

Last name

Will you have any pets living with you? If Yes then

How many dogs?

How many cats?

Which breed(s) are your pets?

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