Tenant Landlord Connection Form
Tenant or Landlord/Workshop or Inquiry Switcher
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TenantInq
LandlordInq
TenantWrk
LandlordWrk
Hidden fields
Service File Name
Tenant Inquiry Form
Landlord Inquiry Form
Tenant Workshop Registration Form
Landlord Workshop Registration Form
We are required to gather this information by our funders
Primary Applicant Contact Information
First Name
MI
Last Name
Date of birth
Street
City
State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Phone Number
Email
Race
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Asian
Black or African American
American Indian or Alaska Native
Native Hawaiian or Pacific Islander
White
American Indian AND White
Asian AND White
Black or African American AND White
American Indian AND Black
Other multiple race
Ethnicity
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Hispanic, Latino, or Spanish
Non-Hispanic
Additional Information For Tenants
What is your current household size?
How many children (under age 18) live in the household?
Gross Annual Household Income
Is any member of the your household considered disabled?
Please select...
Yes
No
When is the workshop that you want to attend being held?
Additional Information For Landlords
Property owner or manager
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Property Owner
Property Manager
Name of Property Management Company
# of units owned/managed
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1-3
4-6
7-10
10-20
20+
What is the title of the workshop you want to attend?
Please briefly describe the issue that you are hoping the TLC program can help you with:
DISCLAIMER: One Roof does not offer legal advice
I have read the
disclosure and privacy policy form
and consent to the terms.
Yes
Contact Information