Apply — Light of Life Recovery Homes

Please complete all required fields honestly and completely. Submitting this application does not guarantee approval or reservation of a room.

Section 1

Applicant Information

Full Name *Date of Birth *Phone Number *Email Address *Current AddressGovernment-Issued ID Type *ID Number *Upload a Copy of Your ID *Image or PDF, max 10 MB. Stored securely and used only for verification.

Section 2

Employment Information

Employer / CompanyPosition / OccupationLength of EmploymentMonthly IncomeWork Phone

Section 3

Emergency Contact

NameRelationshipPhone Number

Section 4

Rental Information

Desired Move-in DateExpected Length of StayRoom Preference

Private RoomShared RoomNo Preference

Section 5

Additional Occupants

Will anyone else be staying with you?

No Yes

If yes, please provide their names

Section 7

Vehicle Information (optional)

MakeModelColorLicense Plate

Section 8

Personal Reference

NameRelationshipPhone

Section 9

Additional Information

Please tell us about yourself and why you are interested in renting with us.

Section 10

Agreements & Signature

I certify that the information provided is true and complete. I understand that any false or misleading information may result in the rejection of my application or termination of my tenancy. I authorize management to verify the information provided, including employment, rental history, and references. I acknowledge that submitting this application does not guarantee approval or reservation of a room.I have read and agree to the House Rules, including that security cameras operate 24/7/365 in designated common areas, and that tampering with any camera or security equipment is strictly prohibited. Management may update the House Rules with notice.I acknowledge the Privacy Notice: information collected here is used solely to evaluate my application, communicate about it, and manage my tenancy if approved. My information will be kept confidential and only shared as required by law or for legitimate rental verification.

Applicant Signature (type full name) *Date *

By submitting, you consent to the terms above. Your ID upload is stored securely and only accessed by authorized management.

Application Form