H4SO, Inc.
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Application

Residence Application

Please fill this application out Completely.  If you have any question or concerns, feel free to contact Daphne at (407) 300-3252 or email us at housing4so@gmail.com.

Applicant Information (Name of Inmate/Offender)
First Name:
Last Name:
DC or Inmate Number:
Date of Birth:
Name of Institution:
Current Address:

City:
Zip Code: (5 digits)
State:
Release Date:
Prison Contact Person:
Date of Conviction:
Felony or Misdemeanor:
Nature of their current charge/conviction:
Is this an Interstate Compact:
If this is an Insterstate Compact, from which state:
Are there any pending charges anywhere:
Will they be on parole, probation or neither:
How long will they be on parole/probation:
Do they have any mental health issues? If so, please explain:  
Do they have any health issues? If yes, please explain:
Will their health issues require someone else to help care for them? If yes, how much care is required:
Please list any and all substance abuse problems:
Please list any treatment programs the applicant has been involved in:
Will the applicant be able to work?
Is the applicant eligible for Social Security, Medicaid, Medicare, Disability, or VA Benefits? If yes, which ones:

 
Contact Person/Support
First Name:
Last Name:
Address:
Address 2:
City:
State:
Zip Code:
Contact Information
Daytime Phone:
Evening Phone:
Email:
Financial Information
How Will Rent Be Paid:
Expected Rent Amount:
(USD)
Room Request Information
Single or Shared Room:
Other Information
Comments:
I authorize SOHOUSING.COM to verify
my credit and employment history.

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