Our Story Unveiled

At Park Place Commons, our mission is to offer a convenient and supportive living experience for our community members. By prioritizing affordability and comfort, we strive to enhance the quality of life and promote a strong sense of belonging. Join us on this journey of shared living.

Get a Room

Welcome to our concept of shared housing living, where we take pride in offering a space that rivals a 5-star hotel experience. Currently, our available spaces are suited for single occupants only. We do not have availability for families at this time, we invite you to join our waitlist for future space coming soon.

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Welcome to Mem App

Membership Application

Date

Month

Day

Year

First name

Last name

Phone

Last Address (Please your last stable address on your ID)

Emergency Contact Name and Phone Number

Do you understand that this is shared living?

Yes

Do you understand that this is not a landlord/tenant relationship?

Yes

Have you lived in a shared housing before?

Yes

We have house rules to govern the safety and harmony of the home. Would you abide by them?

Yes

Current Living Situation:

Living with Family

Living with Roommates

Group Home Shared Living

Homeless with no permanent housing

How long would you like to be a guest at our home? (You may choose more than one)

1-3 months

4-6 months

7-12 months

1-2 years

How soon do you need housing?

What is your monthly income?

Funding Source

Self-Pay

Social Security Insurance (SSI)

Disability Insurance (SSDI)

Government or State Assistance

Non-Profit Organization-Rent Assistance

If you are self-paying for housing please provide your employer's information for income and stability verification Employer Name:

Employer Contact Phone Number

Supervisor/HR Contact Phone Name and Phone Number

Position/Job Title and Lenth of Employment

Have you been evicted before?

Yes

If yes, when

Have you been convicted of a felony?

Yes

If yes, please explain. Put the estimated date of the warrant/pending charges and the nature of the warrant/charges.

Do you have a registered Emotional Support Animal that will be living with you? If so, what type. Documentation will be required for ESA.

Primary Mode of Transportation

Public Transportation i.e., Taxi Lift Uber

Personal Car

Do you smoke?

Yes

Are you current taking medication?

Yes

Do you need medical assistance? Our homes are not care homes. All members must be able to take prescribed medications and be able to leave facility on their own in any emergency.

Do you understand that this is a shared membership housing and that rooms are book in advance for not less than 2 weeks.

Yes

Do you have the 2 weeks booking and the non-refundable risk fee available today?

Yes

Please include any questions?

Were you referred, if so by whom?

How will you submit your documents?

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I will submit later via email or upload link

Please upload a copy of your ID or Drivers License, Copy of your Social Security Card, Proof of Income (Ex: SSI/SSDI Award Letter Pay Stub

Member will submit their background check payment separately.

By signing this form, I certify that all information provided in this application is true and accurate. I authorize the Park Place Commons East LLC to conduct a non-refundable $25 background check and verify my information.

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Membership Application

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