Create an Account

Your Information

You'll use this information to log in to your account. Choose something that will be easy for you to remember but hard for others to guess.

All fields marked with an asterisk are required!
Your Name
Login ID and Password
User ID: {{IDMUserName}}
User ID: {{IDMUserName}}

Do you have an additional email address of your own that you would like to provide for us to contact you about future housing opportunities? *
Notification:
You may uncheck the boxes above if you do not want notification.
The accessible unit wait list is always open, no subscription required.

Select all the below that apply:

Please check all the boxes that apply to you, so that you can be better matched to a housing unit:

**Homelessness is defined by the US Department of Housing and Urban Development (HUD) as an individual or family who is sleeping in a place not meant for human habitation, such as on the street, in a car, or in a shelter, or, persons who are fleeing domestic violence.

Contact Information - Phone

Your contact information will be used to contact you about future housing opportunities.
Please note: you will be contacted in ALL methods entered.

All fields marked with an asterisk (*) are required.
Do you have your own phone number?
Please select the notification options
Do you have an additional phone number of your own that you would like to enter?

Additional Phone Number

Please select the notification options

Contact Information - Mailing Address

Your contact information will be used to contact you about future housing opportunities.
Please note: you will be contacted in ALL methods entered.

All fields marked with an asterisk (*) are required.
Do you wish to share your mailing address?
Please enter your mailing address (for housing notification)

Contact Information - Alternate Contact

Your contact information will be used to contact you about future housing opportunities.
Please note: you will be contacted in ALL methods entered.

All fields marked with an asterisk (*) are required.
Is there someone else you'd like us to contact for your future housing opportunities? *
Alternate Contact Name
Please enter the information of your alternate contact.
Choose alternate contact method(s)
Alternate Contact Email Address
Alternate Contact Phone Number

Your Information

Full Name
{{FirstName}} {{MiddleName}} {{LastName}}
Email Address
{{EmailId}}
Login User ID
{{IDMUserName}}
Do you have an additional email address of your own that you would like to provide for us to contact you about future housing opportunities?
Yes
No
Additional Email
{{AdditionalEmail}}
Notification:
Notify me when new properties are are added to the Registry
You may uncheck the boxes above if you do not want notification.
The accessible unit wait list is always open, no subscription required.
Self Declaration of Homelessness
**Homelessness is defined by the US Department of Housing and Urban Development (HUD) as an individual or family who is sleeping in a place not meant for human habitation, such as on the street, in a car, or in a shelter, or, persons who are fleeing domestic violence.

Phone

Do you have your own phone number?
Yes
No
Not Provided
Phone Type
Home
Mobile
Work
Not Provided
Phone Number
{{PhoneNumber}}
Notification Options
Text Message
Phone Call
Text and Call
None
Do you have an additional phone number of your own that you would like to enter?
Yes
No
Additional Phone Type
Home
Mobile
Work
Not Provided
Additional Phone Number
{{AdditionalPhoneNumber}}
Notification Options
Text Message
Phone Call
Text and Call
None

Mailing Address

Do you wish to share your mailing address?
Yes
No
Not Provided
Mailing Address
{{HouseNum}} {{HouseFracNum}} {{LutPreDirCd}} {{StreetName}} {{LutStreetTypeCD}} {{Unit}}
{{City}}, {{LutStateCD}} {{Zip}}

Alternate Contact

Is there someone else you'd like us to contact for your future housing opportunities?
Yes
No
Not Provided
Full Name
{{AlternateContact_FirstName}} {{AlternateContact_MiddleName}} {{AlternateContact_LastName}} Not Provided
Alternate Contact Method(s)
Email
{{AlternateContact_Email}} Not Provided
Phone Type
Home
Mobile
Work
Not Provided
Phone Number
{{AlternateContact_PhoneNumber}}
Notification Options
Text Message
Phone Call
Text and Call
None
Mailing Address
{{AlternateContact_HouseNum}} {{AlternateContact_HouseFracNum}} {{AlternateContact_LutPreDirCd}} {{AlternateContact_StreetName}} {{AlternateContact_LutStreetTypeCD}} {{AlternateContact_Unit}}
{{AlternateContact_CityName}}, {{AlternateContact_State}} {{AlternateContact_Zipcode}}