South Suburban Housing Center

Please fill out the following information and a pdf file with our rental referral information will be emailed to you. Note: SSHC is required to report this demographic data for all recipients of our counseling and education programs; your answers will not affect the services you receive.

* indicates required

First Name *

Last Name *

Email Address *

Phone Number *

( ) -

Age *

Monthly Household Income *

Household Size *

Number of Children in Household (under 18 y.o.) *

City *

Zip Code

Gender *

Male
Female
Non-Binary/Other
Prefer not to say

Are You Homeless? *

Are you a Veteran? *

Ethnicity *

Hispanic
Non-Hispanic
Prefer Not to Say

Rental Referral Information