Early Bird Allston Brighton Senior Application Support
Thank you for your interest in Allston Housing at the Hill! By filling out this form, you will be put on a list to be contacted about application information for this affordable housing opportunity.
Contact Information
First Name
Last Name
Email Address
Phone Number
What neighborhood do you live in?
Allston (02134)
Brighton (02135)
Other
Unsure
Address
Preferred method of contact:
E-mail
Phone
Mail
Primary Language
Please select...
English
Spanish
Arabic
Bosnian
Chinese (Mandarin)
Chinese (Cantonese)
Creole
French
Italian
Japanese
Maay Maay
Khmer
Nepali
Portuguese
Somali
Tagalog
Urdu
Vietnamese
Other
Are you proficient in English?
Yes
No
If Other, please list:
Personal Information
What is your birth year?
Are you a current resident of Allston Brighton CDC Housing?
Yes, current resident
No, former resident
No, I have never lived in Allston Brighton CDC housing
What is your gender?
Male
Female
Other
Prefer not to say
What is your annual income?
Under $24,000
$24,000-$47,999
$49,000-$71,999
$72,000-$95,999
$96,000 or more
What is your employment status?
Employed
Unemployed
Self-Employed
Retired
Household Information
Would you consider re-locating to another housing location if it was affordable, comfortable, safe, and within the Allston Brighton neighborhood?
Yes
No
Why or why not?
Would you like to tell us more information about your living situation? Questions will pertain to ownership status (rent versus own), household size, etc.
Yes
No
Which of the following best describes your current living situation?
Rent
Own
Living with Friends/Family
Shelter (Emergency or transitional)
Hotel or Motel
Other temporary living situation (trailer park, campground, car, park, public places, etc.)
How long have you lived at your current residence?
0 to 3 years
3 to 5 years
6 to 10 years
Over 10 years
How many people live in your household? Please include yourself
One person
Two persons
Three persons
More than 3 people
Do you have someone who regularly visits you and assists you if necessary?
Yes
No
Contact Information