AMAAD Housing Application 
Do you have a valid ID? *
What is your gender? *
Ethnicity *
Race *
Would you be comfortable living in a home where Black Gay Men are openly celebrated? *
Do You Currently Pay Rent? *
Have you ever lived in a transitional living facility before? *
Are you a student? *
What is your income source? *
In the last 30 days have you used any substances? *
Are you currently or planning on attending any outpatient or mental health therapy? *
Are you currently taking any medications? *
Do you currently have a case manager at any agency? *
Have you ever been convicted of a felony? *
Are you currently on probation or parole? *

Over the past 2 weeks, how often have you been bothered by any of following problems?