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FAQs
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Contact

Veteran Housing Pre-Qualification Application

Thank you for your interest in Freedom Haven Holdings. This brief application helps us determine whether you may qualify for our shared housing program. Submission does not guarantee approval or placement.

Full Name *

Phone Number *

Email Address *

Current City & State *

Date of Birth *

Are you a Veteran? *

Yes No Active Duty National Guard Reserve

Branch of Service

Type of Discharge

Which best describes your current living situation? *

Homeless Emergency Shelter Transitional Housing Staying with Family / Friends Renting Other

Desired Move-In Date *

How will your housing be paid? *

VA Benefits HUD-VASH SSVF Employment SSI / SSDI Social Security Pension Other

Approximate Monthly Income *

Were you referred by a Case Manager or Agency? *

Yes No

Are you comfortable sharing a bedroom with one other approved veteran? *

Yes No

Can you follow community rules regarding respect, cleanliness, quiet hours, and maintaining a drug-free environment? *

Yes No

Briefly tell us why you are seeking housing and what your goals are over the next 6–12 months. *

Emergency Contact

Name

Relationship

Phone Number

I certify that the information provided is true and accurate to the best of my knowledge. I understand this is only a preliminary screening and does not guarantee housing or acceptance into the Freedom Haven program.

Typed Name *

Freedom Haven Holdings LLC

Affordable and comfortable shared living homes for mature and responsible adults, including independent seniors and veterans.

contact

(888) 212-7378
customercare@freedomhavenholdings.com

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