HOST / Landlord
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If you wish to register with us soon, please complete
the following form to help speed the interview process.



YOUR CONTACT INFORMATION

My need is:    Immediate  Soon  Other

Fields marked with * are required - so that we may contact you

Salutation:

*First Name & MI:
*Last Name:
Street Address:
Address 2: 
City: State: Zip:
*Home Phone:  Cell Phone: Work Phone:
Phone Me At: Home Cell Work
Best Time Is: Morning Afternoon Evening
*E-mail address: [important]
How did you find us?

YOUR SITUATION

Landlord - have a room    Tenant - need a room    Start a new place with someone else   

Male    Female

Type of Place: Price Range:
Total Square Feet Age Range:


Your Occupation:
Please check all that apply.

Student Single Divorced Widowed
I have children Children ok I have pets Pets ok
I smoke Smoker ok Smoke in room Smoke outside
I have furniture Need furniture Bedroom only Can Store
Race is an issue Race not an issue Sexual preferrance an issue Sexual pref not an issue
Will live w/straight Will live w/gay Will live w/male Will live w/female
Short Term OK Long Term Only


Please return a copy of this form to my email address above.

Message:

During your personal interview we will review these items in greater detail and address any additional concerns you may have.  Also you will be asked for your drivers license or equivalent, two personal references and your employment information.



How To Contact Us:
Office:  248.644.6845
Click To Send Email
Fax:     248.644.6898


Home Mate Specialists
30115 Greenfield Road
Southfield, Michigan 48076
          Home Mate Office


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