Home Provider Online Application

HomeShare asks for references in order for us to try to find the right person for you. Please provide 4 references, including 1 employment reference if applicable. Together the references should cover a span of at least 5 years to the present.

ACCEPTABLE — Past or Present Roommates • Landlords • Employers • Co-workers • Friends • Neighbors
NOT ACCEPTABLE — Family Members • Significant Others (e.g., boy/girl friends, spouses or life-partners)

Personal references known at least 5 years may be substituted for landlord or professional references at the discretion of HomeShare. Please notify your references that HomeShare will be calling them. Please understand that if you have trouble reaching them, we will have the same trouble, and your application may be delayed.

Please provide the following personal details to help HomeShare find the right person for you.

(Voluntary – for statistical purposes only)

I hereby acknowledge that all the information I have given in this application is true and complete to the best of my knowledge. I certify that I have read and agree to the 1) Program Exit Guidelines and 2) Participation Agreement and Release. I consent to having HomeShare check references and conduct a background check. Please fill out the Applicant Background Check Form to get started and email it to Home.Share@ventura.org or mail it to 646 County Square Drive, Suite 100, Ventura, CA 93003.

I understand that the information my references provide will not be disclosed to me as part of the screening process. I understand that false, misleading or incomplete information may make me ineligible to receive HomeShare services.

Before submitting your application, please check below if you would like to have a VCAAA representative contact you with information about other Agency or Community services. VCAAA services may be available if program eligibility requirements are met, and if funding for the services continues to be available.