top of page
Shared
Companion Homes
Home
About Us
Services
Seniors
Veterans
Roommate
Happy Companions
Contact Us
Apply Today
Personal Information
First name
*
Last name
*
Date of Birth
*
Month
Day
Year
Branch of Service
*
Years of Service
*
Phone
*
Email
*
Current Address
*
Emergency Contact (Name & Phone)
Roommate Preferences
Do you have any pet allergies?
*
Yes
No
Are you willing to live with pets?
*
Yes
No
If yes, what kind?
Do you have any pets?
*
Yes
No
If yes, what kind?
Do you prefer to live with fellow veterans?
*
Yes
No
Smoking & Substance Use
Do you smoke or use any substances?
*
Yes
No
Are you okay with living with someone who does?
*
Yes
No
Daily Routine & Lifestyle Compatibility
What is your typical daily schedule? (Early riser, night owl, etc.)
*
How often do you have visitors or family over?
*
Household Contributions
Are you comfortable participating in shared household tasks? (Cleaning, cooking, etc.)
*
Yes
No
Would you rather do chores on a schedule or just help out as things need to be done?
*
Social Engagement & Interests
What are your hobbies or social interests?
*
Would you like to participate in organized activities within the home/community?
*
Yes
No
Consideration & Interaction
How do you handle situations where a roommate needs help with something small, like carrying groceries or fixing something?
*
What do you think makes a good roommate?
*
How do you feel about occasionally doing something nice for your roommate, like making coffee or sharing a meal?
*
Any additional info we need to know?
Submit
bottom of page