Apply for Housing — DALS, LLC

All fields in Sections 1–4 are required. Enter N/A if a field does not apply to you.

First Name *

Middle Name *

Last Name *

Preferred Name / Nickname *

Date of Birth *

Social Security Number *

Other names / aliases used *

Age *

Gender *

Race / Ethnicity *

Phone Number *

Alternate Phone Number *

Email Address *

Current Address *

City *

State *

ZIP Code *

County *

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone *

Section 2 — Housing Requested

Security Deposit Available First Month Rent Available Need Assistance With Move-In Costs

Section 3 — Household Information

Applying for *

Number of Adults *

Number of Children *

Names, Genders, and Ages of Children *

Transportation — do you have your own transportation or rely on the city bus / other transportation? *

Please note: for individuals with children, the monthly rate may increase due to utility usage — no more than $25 per child.

Do you have a mental health diagnosis? *

Yes No

Do you (or a household member) have a physical disability? Service Animal Pets

Are you currently on Medicaid? *

Yes No

Are you interested in Peer Support Services? (Free)

Peer Support Services are completely free. A Peer Support Specialist is someone who has personally experienced mental health or substance-use challenges and is trained and certified to help others on their own recovery journey. They listen without judgment, share what has worked for them, help you set goals, connect you to community resources, and walk alongside you as you build stability — including support with housing, daily living skills, and staying well. Peer Support is not therapy or medical treatment; it is encouragement and guidance from someone who has been there.

Section 4 — Income Information

Select all that apply (at least one required — choose "No Income" if none apply).

Monthly Income Amount *

Employer Name *

Length of Employment *

Pay Frequency *

Additional Sources of Income *

Expected Changes in Income *

Section 5 — Document Uploads

PDF, JPG, or PNG up to 15MB each. All documents are optional — upload what you have and our team will follow up if anything else is needed.

Government ID Add file(s)

Proof of Income Add file(s)

Housing Voucher Documentation Add file(s)

Referral Letter Add file(s)

Probation/Parole Documentation Add file(s)

Disability Documentation Add file(s)

Supportive Services Documentation Add file(s)

Birth Certificate Add file(s)

Court Documents Add file(s)

Section 6 — Housing History

Ever Evicted Money Owed to Landlord Ever Denied Housing

Rental reference (current or most recent landlord) — enter N/A if you have never rented.

Section 7 — Criminal Background

DALS, LLC believes in second chances. Criminal history does not automatically disqualify applicants.

Referral documentation (optional) Add file(s)

Section 8 — Accessibility & Services Requested

Section 9 — Additional Information

Section 10 — Certifications & Consent *

I certify that the information provided is true and accurate. I authorize DALS, LLC to verify information provided in this application. I understand that submission does not guarantee housing placement. I consent to DALS, LLC sharing my application with vetted housing providers and referral partners. I understand that DALS, LLC may conduct background, rental history, and income verification checks. Can you follow the house visitor rules? I agree to follow the house rules on visitors: no more than 1 visitor at a time, and no visitors between 10:00 PM and 8:00 AM.

House Rules *

These house rules apply to all DALS, LLC properties unless otherwise indicated for a specific home. House rules may be amended as needed; residents will be notified of any changes.

Your initials (I have read and agree to follow the House Rules) *

DALS, LLC Housing Application Portal

Welcome to DALS, LLC Housing Application Portal

Section 1 — Applicant Information