top of page

Home
Services
Leadership
Photo Gallery
Events
Become A Part Of Our Village
Make A Donation
- Financial Contribution
- Items
Contact
More...

Use tab to navigate through the menu items.

Donate

Become A Part Of Our Village

Resident Application

First name:

Last name:

Date of Birth:

Phone Number:

Email Address:

Social Security Number:

Current Address:

How long have you lived at this address

Previous Address (if applicable):

Name of Fiduciary:

Phone Number:

Source of Income: *

Full Time

Part Time

Student

Unemployed

Retired

VA Benefits

Social Security Benefits

Address:

Email Address:

Current Employer:

Supervisor's Name:

Monthly Income:

Job Title:

Phone Number:

Length of Employment:

Please attach the following documents with your application:

· Identification (Drivers License, State ID, VA ID, Passport, Green card)
· Proof of Income (Award letter, pay stubs, offer letter, etc.)
· Any additional documents or information you believe that may support your application

Identification:

Upload File

Upload supported file (Max 15MB)

Proof of Income:

Upload File

Upload supported file (Max 15MB)

Additional Documentation:

Upload File

Upload supported file (Max 15MB)

References: Please provide three references, one being the nearest relative:

Full Name:

Relationship:

Phone Number:

Full Name:

Relationship:

Phone Number:

Full Name:

Relationship:

Phone Number:

Criminal Background Check Consent: I hereby authorize E’Rame Solutions to conduct a criminal background check as part of the application process. I understand that this may include obtaining information from public and private sources.

I agree to the Criminal Background Check: *

Yes

Declaration: I certify that all the information provided in this application is true and accurate to the best of my knowledge. I understand that any false or misleading information may result in the rejection of my application.

Sign Here

Date:

Desired Move-in Date:

Thanks for interest in Veterans Village of the Carolinas! We'll get back to you soon.

Veterans Village of the Carolinas

"Veterans Village of the Carolinas is committed to help transition homeless and at-risk Veterans to self-sufficiency through housing programs and supportive services."

Email: info@vavillage.org

Phone: 980-766-7441

Quick Links

Become A Part of Our Village

Make A Donation

Contact

bottom of page

Become A Part Of Our Village

Resident Application

Please attach the following documents with your application: · Identification (Drivers License, State ID, VA ID, Passport, Green card) · Proof of Income (Award letter, pay stubs, offer letter, etc.) · Any additional documents or information you believe that may support your application

References: Please provide three references, one being the nearest relative:

Criminal Background Check Consent: I hereby authorize E’Rame Solutions to conduct a criminal background check as part of the application process. I understand that this may include obtaining information from public and private sources.

Declaration: I certify that all the information provided in this application is true and accurate to the best of my knowledge. I understand that any false or misleading information may result in the rejection of my application.

Please attach the following documents with your application:

· Identification (Drivers License, State ID, VA ID, Passport, Green card)
· Proof of Income (Award letter, pay stubs, offer letter, etc.)
· Any additional documents or information you believe that may support your application