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“Empowering People to find positive solutions to conflict”

Tenant Portal

If you are behind in rent and would like to submit yourself into the program, please fill out this form below and we will contact you.

Tenant Intake Form

Please complete all required fields!

First Name(*)

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Phone Number(*)

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Last Name(*)

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Email Address(*)

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Address(*)

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City(*)

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Have you received previous rental assistance?(*)

Yes No

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Number of Months behind in rent(*)

1 month2 months3 months4 months5 months6 months7 months8 months9 months10 months11 months12 months Invalid Input

Zip Code(*)

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Has your landlord served you with a 14 day notice to vacate?(*)

Yes No

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Property Name(*)

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Landlord’s Name(*)

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Landlords Email

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Landlords Phone

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File upload of notices or photos

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Anything else you would like us to know?

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Security Check(*)

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Submit

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Links to Local Resources

Clark County Volunteer Lawyers Program
SHARE Vancouver
Council for the Homeless

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