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By sharing your home you can:
Earn extra income to cover housing costs
Get the extra help needed to stay at home
Share household duties
Save money to travel
Register here below to share your home
Address Line 2
Note: Your address will not be shared with a potential roommate until they are vetted through a background check, interview process, and discussion facilitated by an ALA employee. Providing your address helps us identify potential roommates in your neighborhood.
Why have you decided to share your home?
Examples: extra income, companionship, help with household tasks
Rent + Living Support Services
If you prefer Living Support Services, which do you need?
What rent amount will you charge? (per month)
Have you ever shared housing with a non-family member/spouse?
Are you currently employed?
Tell Us About Your Home
Are you offering a private bathroom?
Are there stairs in the home?
Is the room for rent furnished?
If furnished, please describe
Examples: Bed frame with mattress included, desk, lamp
What will your guest have access to?
Access to Kitchen
None of the Above
Anything else you would like to mention about your home?
Tell Us About Yourself
Describe your typical daily schedule
How do you rate your housekeeping standards?
Scale of 1 to 10, with 10 being the cleanest
How often do you have company?
Scale of 1 to 5, with 1 being rarely and 5 being daily
How often do you have overnight company?
Scale of 1 to 5, with 1 being rarely and 5 being nightly
Are you fluent in any language other than English?
Examples: Spanish, Mandarin, Armenian
Do you have pets?
If yes, what kind?
Do you smoke?
Do you drink alcohol?
How long have you resided in California?
Rental Duration Preference
1 Year or longer
How clean do you prefer your roommate to be?
Scale of 1 to 10, with 10 being the cleanest
Amount of Interaction
Scale of 1 to 5: Looking for a close friendship is 5, Prefer to keep to myself is 1
How often is it OK for your roommate to have company?
Scale of 1 to 5: with 1 being rarely and 5 being daily
COVID-19 Roommate Expectations
Same as mine
Similar but willing to negotiate differences
Examples: Wearing a mask, social distancing
Do you have a special diet that a roommate would need to be aware of?
Examples: Kosher, vegetarian/vegan, salt-free
Emergency Contact Name
Emergency Contact Relation
Examples: Son, daughter, cousin, close friend
Emergency Contact Phone Number
How did you hear about our Shared Housing program?
Referral/word of mouth
If Referral, please list organization or individual
If Other, please explain
Investigative Consumer Report Authorization
By submitting this form, you affirm that you understand and agree that ALA Senior Living (“ALA”) may obtain in connection with the hiring of a dwelling unit, as defined in subdivision (c) of Section 1940 of the California Civil Code, and/or for legitimate business needs in connection with a business transaction with which you are involved: • consumer credit reports bearing on your creditworthiness, credit standing and credit capacity; and • investigative consumer reports, which may include information concerning your character, general reputation, personal characteristics, mode of living, work habits, job performance, experience, abilities and the reasons for termination of past employment. The reports may be used by ALA as a factor in decisions relating to its housing programs, including potential home-sharing arrangements. Such reports may be requested by ALA or on behalf of ALA. The reports may be based on information obtained through: personal interviews with your past and current neighbors, friends or associates, or others who may have relevant knowledge; and information obtained from various federal, state, and other agencies, including public and private sources that maintain records concerning, without limitation, your driving record, credit history, criminal record, civil matters, previous employment, educational background and professional licensing, if any. The consumer credit reporting agency or investigative consumer reporting agency (the “Agency”) providing a report subject to this notice is: Apartment Owners Association of California, Inc. You have the right, upon written request made within 30 days after receipt of this notice, to receive a written disclosure of the nature and scope of any investigation. If an adverse decision is made affecting your participation in ALA’s housing programs based on a consumer credit report or an investigative consumer report, ALA will provide a copy of the report to you and a written description of your rights under the Fair Credit Reporting Act before taking adverse action based on the report.
ADDITIONAL NOTICE UNDER CALIFORNIA LAW
You have a right to obtain a copy of any consumer credit report or investigative consumer report obtained by ALA by checking the box provided below.
I request a copy of any consumer credit report or investigative consumer report obtained by ALA
On the following Agency website, you will be able to find additional information concerning the privacy practices of the Agency, including whether the Agency will transfer any of your personal information to any third party outside the United States or its Territories: https://aoausa.com/ During normal business hours, you may view the file maintained on you by the Agency named above. You may also obtain a copy of the file upon submitting proper identification and paying the costs of duplication services, by contacting the Agency named above in person or by mail. You may also receive a summary of the file by telephone. The Agency is required to have personnel available to explain your file to you and the Agency must explain to you any coded information appearing in your file. If you appear in person, a person of your choice may accompany you, provided that this person furnishes proper identification.
Date of Birth
MM slash DD slash YYYY
Driver License # / State
I authorize for the below mentioned items:
I hereby authorize ALA to obtain consumer credit reports and investigative consumer reports about me in connection with the hiring of a dwelling unit, as defined in subdivision (c) of Section 1940 of the California Civil Code, and/or for legitimate business needs in connection with a business transaction with which I am involved. I understand that ALA and its agents are not responsible for the accuracy or completeness of the information contained in any such reports.
TO THE FULL EXTENT PERMITTED BY LAW, I HEREBY RELEASE ALA AND ITS AGENTS FROM ALL LIABILITY AND CLAIMS RELATING TO THE INFORMATION OBTAINED FROM ANY AND ALL SOURCES IN CONNECTION WITH SUCH REPORTS.
I acknowledge that a fax or copy of this Notice and Authorization bearing my signature shall be as valid as the original for all purposes. This Notice and Authorization is valid for all federal, state, county, and local agencies and authorities, and for all public and private sources that maintain records concerning my past activities. I further acknowledge that I have received a copy of “A Summary of Your Rights under the Fair Credit Reporting Act” and any notices required under the California Consumer Credit Reporting Agencies Act and the California Investigative Consumer Reporting Agencies Act.
I understand that this authorization is not a guarantee for housing and does not guarantee housing within a specified time period. I certify that the information on this form is true and correct. I understand that any false statements or misleading information may result in disqualification from or consideration for ALA’s housing programs.
I understand that the $17 fee is non-refundable, regardless of acceptance into the program.
Background Check Application Fee
Supported Credit Cards: MasterCard, Visa
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