Application template review

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Image
City of Los Santos
Rental Assistance Application
  • PERSONAL INFORMATION
    • Forename & Surname: Answer Here
      Date of Birth: Answer Here
      Residence Address: Answer Here
      Phone Number: Answer Here
      E-mail address: Answer Here

      Select your citizenship status:
      • U.S. Citizen
        Non-U.S. Citizen
    • Select your gender:
      • Male
        Female
        Other
  • HOUSEHOLD MEMBERS
  • Forname & Surname: Answer Here
  • Date of Birth: Answer Here
  • INCOME INFORMATION
  • Do you have any income?:
  • If yes, how much do you receive per month?: Answer Here
  • What is the source of your income?: Answer Here
  • INCOME INFORMATION
  • Do you pay rent or own a home?: Rent / Own
  • If rent, how much is your monthly payment?: Answer Here
  • If own, how much is your monthly mortgage payment?: Answer Here
  • Do you pay for utilities?: Yes / No
  • If yes, how much do you pay per month?: Answer Here
  • ADDITIONAL INFORMATION
  • Do you have any disabilities or medical conditions?: Yes / No
  • If yes, please explain: Answer Here
  • Do you receive any other benefits?: Yes / No
  • If yes, please specify: Answer Here



Declaration:
I, [Your Name], hereby declare that all the information provided in this application is true and accurate to the best of my knowledge. I understand that any false information may result in disqualification from receiving assistance.


Signature:
Date:
  • (( OUT OF CHARACTER ))
    • Country of Residence & Timezone: Answer Here

      Discord ID: Answer Here

      Please list all your characters and their levels:
      • Name Surname
      • Name Surname
      • ...

Template

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  • Application Subject

    Code: Select all

    #DSS-01-25 - Rental Assistance | Firstname Lastname
    Application Form

    Code: Select all

    [divbox=white][center][img]https://i.imgur.com/b9f9JTN.png[/img][/center]‎
    [center][size=110]City of Los Santos[/size]
    [size=130][color=#000000][b]Rental Assistance Application[/b][/color][/center][/size]
    [list=none][divbox=black][center][color=#FFFFFF][b]PERSONAL INFORMATION[/b][/color][/center][/divbox][/list]
    [list=none][list=none]
    
    
    [b]Forename & Surname:[/b] [i]Answer Here[/i]
    [b]Date of Birth:[/b] [i]Answer Here[/i]
    [b]Residence Address:[/b] [i]Answer Here[/i]
    [b]Phone Number:[/b] [i]Answer Here[/i]
    [b]E-mail address:[/b] [i]Answer Here[/i]
    
    [b]Select your citizenship status:[/b]
    [list=none]
    
    [cb][/cb] U.S. Citizen
    [cb][/cb] Non-U.S. Citizen
    [/list][/list]
    [list=none]
    [b]Select your gender:[/b]
    [list=none]
    [cb][/cb] Male
    [cb][/cb] Female
    [cb][/cb] Other
    [/list][/list][/list]
    [list=none][divbox=black][center][color=#FFFFFF][b]HOUSEHOLD MEMBERS[/b][/color][/center][/divbox][/list]
    [list=none]
    [*] [b]Forname & Surname[/b]: [i]Answer Here[/i]
    [*] [b]Date of Birth[/b]: [i]Answer Here[/i]
    [*] [b]List the Name and Ages of everyone living in your household[/b]: [i]Answer Here[/i]
    [/list]
    [list=none][divbox=black][center][color=#FFFFFF][b]INCOME INFORMATION[/b][/color][/center][/divbox][/list]
    [list=none]
    [*] [b]Do you have any income?: [/b][cb][/cb] 
    [*][b] If yes, how much do you receive per month?:[/b] [i]Answer Here[/i]
    [*] [b]What is the source of your income?:[/b] [i]Answer Here[/i]
    [/list]
    [list=none][divbox=black][center][color=#FFFFFF][b]INCOME INFORMATION[/b][/color][/center][/divbox][/list]
    [list=none]
    [*] [b]Do you pay rent or own a home?:[/b] Rent [cb][/cb] / Own [cb][/cb]
    [*][b] If rent, how much is your monthly payment?:[/b] [i]Answer Here[/i]
    [*] [b]If own, how much is your monthly mortgage payment?:[/b] [i]Answer Here[/i]
    [*] [b]Do you pay for utilities?:[/b] Yes [cb][/cb] / No [cb][/cb]
    [*] [b]If yes, how much do you pay per month?:[/b] [i]Answer Here[/i][/list]
    
    
    [list=none][divbox=black][center][color=#FFFFFF][b]ADDITIONAL INFORMATION[/b][/color][/center][/divbox][/list]
    [list=none]
    [*] [b]Do you have any disabilities or medical conditions?:[/b] Yes [cb][/cb] / No [cb][/cb]
    [*] [b]If yes, please explain:[/b] [i]Answer Here[/i]
    [*] [b]Do you receive any other benefits?:[/b] Yes [cb][/cb] / No [cb][/cb]
    [*] [b]If yes, please specify:[/b] [i]Answer Here[/i]
    [/list]
    [hr][/hr]
    [br][/br]
    [b]Declaration:[/b]
    I, [b][Your Name][/b], hereby declare that all the information provided in this application is true and accurate to the best of my knowledge. I understand that any false information may result in disqualification from receiving assistance.
    [br][/br]
    [b]Signature:[/b]
    [b]Date:[/b]
    [list=none][divbox=black][center][color=#FFFFFF][b](( OUT OF CHARACTER ))[/b][/color][/center][/divbox][/list]
    [list=none][list=none]
    [b]Country of Residence & Timezone[/b]: [i]Answer Here[/i]
    
    [b]Discord ID[/b]: [i]Answer Here[/i]
    
    [b]Please list all your characters and their levels[/b]:
    [list=none]
    [*] Name Surname
    [*] Name Surname
    [*] ...
    [/list]
    
    [/list][/list]
    [/divbox]