Housing Director Service Agreement

Name/Company*

Email address*

Address*

Telephone #*

Do you have bed availability?*

Yes

No

Is your home co-ed?*

Yes

No

What type of participants do you house?*

Do you understand this a housing coordination agreement and placement is not guaranteed?*

Yes

Do you understand if placement occurs there will be an additional placement fee?*

Yes

Do you agree to a visit to your home to ensure cleanliness and safety?*

Yes

404-491-1414

info@unityindependenthousing.com

5055 Memorial Drive Suite A #233

Stone Mountain, GA. 30083