Representative Submitting Application on Behalf of Applicant (Include Title Or Relationship with Client.) If No One, TYPE: (I AM THE APPLICANT) *

First Name

Last Name *

Street Address *

City *

State *

Country *

Postal code *

Phone *

Email *

Are you 18 or Older? *

Date of birth *

Select which best describes you. *

How soon do you need housing? *

Gender (all participants are thoughtfully matched with same gender roommates.) *

We offer Private Rooms & Shared Rooms. Select which room type will best accommodate you and your monthly budget. *

Are you able to independently perform daily self-care tasks and manage your day-to-day activities, such as bathing, dressing, cooking, cleaning, managing medications, & Ect.? *

List All Verifiable Sources of Income *

Length Of Employment *

Attach Proof Of Income (2 recent pay stubs, benefit letter, etc.) *

Attach Additional Proof Of Income (2 recent pay stubs, benefit letter, etc.) *

By checking this box, I acknowledge Fresh Start Now is a private, independently operated co-living housing provider offering affordable shared living spaces for college students, independent seniors, and veterans. We are not affiliated with government housing programs, veteran services, assisted living facilities, or student dormitories.

All applicants are subject to background checks, verification of income, and approval based on availability. Pricing, availability, and amenities may vary by location and are subject to change without notice. While we aim to foster a safe and respectful community, each resident is responsible for maintaining shared spaces and abiding by house rules and Program Participant Agreements Rules.

Fresh Start Now does not provide medical care, clinical services, or 24-hour supervision. Our co-living model is intended for independent individuals capable of managing their daily living needs.

By applying or residing in a Fresh Start Now property, you acknowledge and accept these terms.

I certify that the information provided is true and complete.
I understand that a background check will be conducted.
I understand that this is independent living and Fresh Start Now does not provide medical or assisted care.
I agree to follow all house rules and community guidelines if accepted.

By checking this box, I consent to receive marketing and promotional messages, including special offers, discounts, new product updates among others. Message frequency may vary. Message & Data rates may apply. Reply HELP for help or STOP to opt-out.

I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.

Upload (Front) Driver's License Or State Issued ID *

Upload (Back) Driver's License Or State Issued ID *

Applicant Signature *

Clear

SUBMIT APPLICATION HERE!