Seeking Room Affordable Living for the Aging

Housing Seeker Application

This application takes 15 to 20 minutes to complete.
This project is funded in part by L.A. Care Health Plan and will benefit low-income and uninsured residents of Los Angeles County
BEFORE PROCEEDING

Please review our current room listings before applying. If you don’t see a room that fits your preferences, we may not be able to match you at this time. Availability changes frequently, but we cannot predict which room types, prices, or locations will become available or when.

Affordable Living for the Aging (ALA) shares room listings for informational purposes only and cannot guarantee a roommate match. Matching depends on steps such as an initial phone call, a home visit, and a trial period. Final placement decisions are made by the home provider.

Available Room Listings

Staff may need up to 5-7 working days to review your application. If you need urgent housing assistance or other related resources, please click here: Los Angeles County Housing and Housing Subsidies

If you need assistance completing the form, please email SharedHousing@alaseniorliving.org
Housing Seeker Minimum Requirements
- You are a current resident of Los Angeles County.
- You receive an income of at least $1,200 every month.
- You have never been convicted of a crime.
- You have never been evicted.
- You are able to perform all activities of daily living without assistance from others.
Please Note:

Once we confirm that you meet the eligibility requirements and are a potential candidate for one of our current rooms, we will require a $17 payment for a background check.
I certify that I meet ALL of the eligibility criteria stated above. I also understand that I will be required to pay $17 for a background check if I am confirmed as a potential candidate for housing.

Program Participation Guidelines – ALA Shared Housing

At ALA, we’re committed to creating a positive, respectful, and supportive housing experience for everyone. To help ensure the program runs smoothly and fairly for all participants, we ask that applicants follow a few important guidelines throughout the application and placement process.

We understand that sometimes challenges come up. However, please note that if certain requirements aren’t met, we may not be able to continue your participation in the program. Below are some examples of situations that could lead to withdrawal from the program:

1. Background Check Not Completed or Passed
A background check is a standard part of the application process. If this step isn't completed or doesn’t meet program criteria, we won’t be able to move forward with placement.

2. Unresponsive References
References help us get a full picture of your fit for the program. If we’re unable to reach them or confirm your information, it may affect your eligibility.

3. Missing Proof of Income
Providing accurate income documentation is key to determining your eligibility. If this information isn’t submitted, we may not be able to complete your application.

4. Incomplete Identification Documents
We need a full set of ID documents to confirm your identity and eligibility. Missing documents may delay or prevent your placement.

5. Consistent missed Scheduled Meetings
Meetings help keep your application and housing search on track. If multiple appointments are missed without notice, it could impact your participation in the program.

6. No Follow-Up with Roommate Referrals
We encourage timely communication with potential roommates once referrals are provided. A lack of follow-up may be interpreted as disengagement from the program.

7. Unkind or Disrespectful Behavior
We’re all here to support each other. We ask all participants to maintain respectful and kind communication. Inappropriate or hostile behavior toward staff or fellow participants may lead to removal from the program.
I confirm that I have read and understood the disclaimer above.
Background Information
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Email*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
CallTextEmail
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What is your current rent?*
Please round up to the nearest whole number. Do not include $ symbol.
Landlord (Name/Contact Info)
If you're experiencing difficulty uploading documents,
click here to send us a message.
We are here to assist you!
Please check this box if you need assistance uploading your documents. By checking the box, you can submit your application without the documents. However, you MUST complete it during your interview with an ALA staff member.
Upload One Form of Identification*

Example: Driver's License, Passport, Permanent Resident Card, Military ID,etc.
Cancelof
Upload Proof of Income (Two Months)*

Example: SSI, Paystubs, Bank Deposits
Cancelof
What's your total monthly income?*
Please round up to the nearest whole number. Do not include $ symbol.
Social SecurityEmploymentPensionOther
What is the maximum amount of rent you can afford to pay?*
Please round up to the nearest whole number. Do not include $ symbol.
To help us find the best housing for you, we ask for two references (e.g., a previous landlord, an employer, or a family member or friend). These references help us understand your background and ensure we can support you effectively in finding a suitable place to live. If you have questions or experience any issues with this form,
click here to send us a message.

REFERENCE #1
R1 Name*

First NameLast Name
R1 Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
R1 Email
example@example.com
REFERENCE #2
R2 Name*

First NameLast Name
R2 Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
R2 Email
example@example.com
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4. Click “Skip Create an Account.”
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Additional Questions

If you are experiencing issues or have questions,
click here to send us a message.
We are here to assist you!
Internet searchReferral/word of mouth/organizationSocial mediaNews sourceOther
If Referral, please list organization or individual
If Other, please explain
Emergency Contact Name*
Emergency Contact Relation*
Examples: Son, daughter, cousin, close friend
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Waiver and Indemnity Agreement
Affordable Living for the Aging ("ALA") works to bring together persons who are in need of housing. This Waiver and Indemnity Agreement ("Agreement") applies to placement in an ALA-facilitated home-sharing arrangement ("The Program").

ALA does not discriminate on the basis of race, religion, color, national origin, ancestry, marital or veteran status, physical or mental disability, medical condition, genetic information, sex (including breastfeeding and related medical conditions), gender, gender identity, gender expression, age, or sexual orientation, or any other protected characteristic under federal, state, or local law.

ALA is not the agent of any party, but simply acts as a facilitator who provides the opportunity for the parties involved to come together for the purpose of shared housing. The decision to enter into a home-sharing arrangement resides with the program participant. The decision to occupy an ALA-rented unit resides with the applicant.

ALA does not provide any express or implied guarantee of the suitability or success of the home-sharing arrangement. Individuals who apply for and participate in the Program should explore any potential impact shared housing rental income may have on their taxes and/or benefits, prior to sharing. These individuals also should explore any potential impact shared housing may have on their current rental agreement or lease, including obtaining the landlord's approval, if necessary.

In consideration of the foregoing, I agree to indemnify and unconditionally release ALA, and each and all of ALA's Board of Directors and Trustees, owners, predecessors, successors, assigns, agents, directors, officers, employees, former employees, representatives, attorneys, accountants, benefit plans, insurers, parent companies, divisions, subsidiaries, affiliates, and all persons acting by, through, or under or in concert with any of them (collectively "Releasees") from any and all individual, class, and/or representative claims, causes of action, losses, demands, complaints and liabilities (including but not limited to attorneys' fees) of any kind whatsoever against the Releasees, relating to my application for, participation in, or termination from the Program, including, without limitation, any and all individual, class, and/or representative claims of any kind whether caused by negligence or otherwise.

I understand that any false statements or misleading information may result in disqualification from or consideration for the Program. I understand that my application and authorization for participation in the Program does not guarantee housing and does not guarantee housing within any specific time period. I acknowledge and agree that I carefully read and considered this Agreement, that I fully understand it, and that I sign this Agreement knowingly and voluntarily, with the intent to be legally bound by its terms.
Please sign here
Required Interview

After clicking the ‘Submit’ button below, you will be directed to a calendar. Please choose a day and time for a 30-minute meeting with our staff. Without an interview, you cannot be considered for matching.
Background Check

If you are experiencing issues or have questions,
click here to send us a message.
We are here to assist you!
I hereby authorize ALA to obtain consumer credit reports and investigative consumer reports about me in connection with the hiring of a dwelling unit, as defined in subdivision (c) of Section 1940 of the California Civil Code, and/or for legitimate business needs in connection with a business transaction with which I am involved. I understand that ALA and its agents are not responsible for the accuracy or completeness of the information contained in any such reports.

TO THE FULL EXTENT PERMITTED BY LAW, I HEREBY RELEASE ALA AND ITS AGENTS FROM ALL LIABILITY AND CLAIMS
RELATING TO THE INFORMATION OBTAINED FROM ANY AND ALL SOURCES IN CONNECTION WITH SUCH REPORTS.

I acknowledge that a fax or copy of this Notice and Authorization bearing my signature shall be as valid as the original for all purposes. This Notice and Authorization is valid for all federal, state, county, and local agencies and authorities, and for all public and private sources that maintain records concerning my past activities. I further acknowledge that I have received a copy of “A Summary of Your Rights under the Fair Credit Reporting Act” and any notices required under the California Consumer Credit Reporting Agencies Act and the California Investigative Consumer Reporting Agencies Act.

I understand that this authorization is not a guarantee for housing and does not guarantee housing within a specified time period. I certify that the information on this form is true and correct. I understand that any false statements or misleading information may result in disqualification from or consideration for ALA’s housing programs.

I understand that the $17 fee is non-refundable, regardless of acceptance into the program.
I authorize and confirm understanding of the items mentioned above.
You have the right to obtain a copy of any consumer credit or investigative consumer report obtained by ALA. To request a copy, check the box.
Date of Birth 2*

MonthDayYear
Date
Driver License # / State
SSN*
To SAVE & CONTINUE later, follow these steps:
1. Click the Save & Continue button below.
2. The screen will dim or go dark—this is normal.
3. Scroll to the top of the page.
4. Click “Skip Create an Account.”
5. Choose one of the following options:
  - Enter your email to send the draft to yourself, or
  - Click “Get Draft Link” to generate a unique link.
    (Make sure to save this link somewhere safe—you’ll need it to return to your draft.)
Should be Empty:

Housing Seeker Application

Background Information

Waiver and Indemnity Agreement