Break The Cycle Properties

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Application

Break The Cycle Properties

Home
About
Services
Application

Experience Break The Cycle Properties

Pre-Screen Application

Full Name*

Phone Number

Email*

Are you able to live independently and take care of yourself?

Yes

No

Need Assistance

Do you have reliable income (SSI,SSDI, JOB, etc)*

Do you have any history convictions or legal issues?

Yes

No

Are you currently taking any medications?*

Yes

No

Are you okay with living in a shared housing environment with other adults?*

Yes

No

Are looking for a private room or shared room?*

Shared room

Private room

Do you have a support system?*

Yes

No

Do you have a pet?*

Yes

No

Do you smoke or use any substances?

Yes

No

Are you comfortable with following house rules (no guests, no drugs/alcohol, quiet hours, etc.)?*

Yes

No

white paper on brown folder beside silver laptop computer

white paper on brown folder beside silver laptop computer

OUR ADDRESS

Burlington, NC

CONTACT US

admin@breakthecycleproperties.com
(336) 585-7974

WORKING HOURS

Monday - Friday
9:00 - 5:00