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THE CALEB FOUNDATION

491 HUMPHREY STREET, SWAMPSCOTT, MA 01907
781-595-4665 * 781-592-0770 (Fax)

PRE-APPLICATION FOR HOUSING
Please fill out the online form and SUBMIT
or DOWNLOAD PDF HERE

If printing out form, please Fax to 781-592-0770 or mail to address above.

PLEASE INDICATE BEDROOM SIZE:







PLEASE INDICATE WHICH PROPERTY(IES)
YOU ARE INTERESTED IN:
Village Heights, Willimantic, CT Chestnut Square Apartments, Lowell, MA
Ledgewood North, Saco, ME The Sirk Building, Lowell, MA
Ledgewood Terrace, Saco, ME Mohawk Forest Apartments, N. Adams, MA
Pineledge Terrace, Saco, ME Rush Square Apartments, Henniker, NH
Pinebrook, Old Orchard Beach, ME Xavier House, Nashua, NH
Olde Woolen Mill, N. Berwick, ME Highland House, Whitefield, NH
The Village at Killingly, Dayville, CT  
PERSONAL INFORMATION
Name*
Address*
City*
State* Zip*
MAILING Address If Different from above
Address
City
State Zip
   
Telephone*
Social Security #*
Date of Birth*
Email*
Members of Household: (Please list everyone who will live in household)
1. Name*
2. Name
3. Name
4. Name
5. Name
6. Name
7. Name
8. Name
 
Total Annual Income $
Total Value of Assets $

If you are in need of a handicap accessible unit due to a mobility impairment,
please select: YES NO

How did you hear about The Caleb Foundation apartment complexes?

Has any member of your household been arrested or convicted of a crime or subject to a lifetime requirement to register as a sex offender? YES NO

The Caleb Foundation is a management company that provides low rent housing to eligible families, elderly households and single people. The Caleb Foundation is not permitted to discriminate against applicants on the basis of their race, color, religion, sex, national origin, disability handicap or familial status. In addition, The Caleb Foundation has a legal obligation to provide "reasonable accommodations" to applicants if they, or any household member, have a disability or handicap.

I understand that this application is not an offer of housing. I understand that it is my responsibility to notify The Caleb Foundation of any change of address, income or family composition. By signing this application I am giving permission to The Caleb Foundation staff to verify any information in this pre-application, perform a credit and criminal record check. Additional information will be provided if requested. I certify that the information I have given in this pre-application is true and correct. I understand that any false statements or misrepresentation may result in the cancellation of this pre-application. I understand that if I am contacted regarding this pre-application and I do not respond, my name will be removed from the waiting list.

APPLICANT’S SIGNATURE*  DATE*

By typing your name, it will act as your handwritten signature in an email application.
   * Required Fields

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donate to the caleb foundation

The Caleb Foundation, Inc., 491 Humphrey St., Swampscott, MA 01907

Phone: (781) 595-4665 • Fax: (781) 592-0770

www.thecalebfoundation.org

© 2010 The Caleb Foundation, Inc.