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CiviCore Housing Services Client Intake & Activation

Organization name

*

Contact Name

*

Contact Email

*

Contact Phone

*

What's your org type?

*

What's your org type?

A

Nonprofit Housing Program

B

Transitional / Supportive Housing Provider

C

Property Management Firm

D

Private Landlord (Voucher-Accepting)

E

Voucher / Rehousing Program

F

Shelter or Emergency Housing Provider

G

Community Development Organization

H

Other (please specify)

If you selected other for org type please specify

*

Property Address

*

Number of Units

*

Voucher accepted? Yes/No

*

Voucher Programs

*

Voucher Programs

Section 8 (Housing Choice Voucher)

Rapid Rehousing

Emergency Housing Assistance

Permanent Supportive Housing

County / City Voucher Programs

Continuum of Care (CoC)

Other

Service Activation Confirmation

By submitting this form, you authorize CiviCore Housing Services to process your request, organize files, and route documentation for compliance and administrative support.

You understand CiviCore does not guarantee any specific agency approvals or outcomes. After submitting, you will be redirected to secure Stripe checkout to complete your activation.

Authorization and Consent

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Authorization and Consent

I authorize CiviCore Housing Services to process and manage documentation and compliance routing related to my housing operations.

Important Acknowledgment

*

Important Acknowledgment

I understand CiviCore does not guarantee housing placements, approvals, or agency decisions. I am purchasing administrative and compliance support services