Rent Well Student Registration

Welcome! Please complete the registration form below.

The following information is collected by the Rent Well Program for both data collection and verifying your Rent Guarantee Program eligibility. The Rent Guarantee Program is a financial incentive for potential future landlords that is paired with this course. Please answer the following questions to the best of your abilities. By completing the form, you agree to allow the Rent Well Program to share the information on this form with the Oregon Housing and Community Services (OHCS) for reporting and monitoring purposes. OHCS oversees the funding for the Rent Guarantee Program. You also agree to allow the Rent Well Program to share limited information with potential landlords as needed to register the Rent Guarantee Program funds after you graduate. This information will only include your name, graduation date, and whether you are eligible for the Rent Guarantee Program at that time. This information may be shared up to 18 months from your graduation date.

Note: If you’re not an Oregon resident, your application will be denied, but if you are planning to move to Oregon within the year, reach out to support@rentwell.org to appeal your application once submitted.

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Preferred First Name(Required)

Preferred Last Name(Required)

Phone(Required)

Email(Required)

Address Line 1

Current or Previous Address

Address Line 2

City(Required)

State(Required)

Zip Code(Required)

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Country

Race

Gender Identity

Date Of Birth(Required)

MM slash DD slash YYYY

Display Language(Required)

Preferred Pronouns

If I use other pronouns, those are

CAPTCHA

What is the highest level of education you completed?

Current Employment Status

Length of Current Status

Veteran Status

How many other individuals in your household are veterans?

Please enter a number greater than or equal to 0.

Are you the head of your household?

Yes

How many people are in your immediate household (include yourself)?(Required)

Please enter a number greater than or equal to 1.

Please add the details of the other members of your household below

Person 2

Person 2 Gender Identity(Required)

Person 2 Date of Birth(Required)

MM slash DD slash YYYY

Person 3

Person 3 Gender Identity(Required)

Person 3 Date of Birth(Required)

MM slash DD slash YYYY

Person 4

Person 4 Gender Identity(Required)

Person 4 Date of Birth(Required)

MM slash DD slash YYYY

Person 5

Person 5 Gender Identity(Required)

Person 5 Date of Birth(Required)

MM slash DD slash YYYY

Person 6

Person 6 Gender Identity(Required)

Person 6 Date of Birth(Required)

MM slash DD slash YYYY

Person 7

Person 7 Gender Identity(Required)

Person 7 Date of Birth(Required)

MM slash DD slash YYYY

Person 8

Person 8 Gender Identity(Required)

Person 8 Date of Birth(Required)

MM slash DD slash YYYY

Do you have any current or past substance use?

Drug use

Alcohol use

None

Do you have any of the following health conditions?

Mental Health Issues

Physical Disability

Developmental Disability

HIV / AIDS

Yes, but I decline to disclose details

No, None

Are you or have you ever been a survivor of domestic violence?

Yes

Are you currently fleeing a domestic violence situation?(Required)

Yes

Are you on probation or parole?

Yes

If you are currently homeless, have you been homeless for 12 or more months?

Yes

Have you been homeless off and on for 4 or more times in the last 3 years?

Yes

In the last six months have you received services through Transition Projects?(Required)

Yes

Were you referred to Rent Well by a service provider who you are currently working with?(Required)

Yes

If so, which agency is it?

If you have a case manager at that agency, would you like us to be able to communicate with them?

Yes

What is your Case Manager’s Name?

What is your Case Manager’s Contact Info?

We communicate most often through email. What is your preferred communication style?

What device(s) are you likely to use most often when taking this course?(Required)

Android Phone

iPhone

Tablet

iPad

Windows Computer

Apple Computer

Unknown

Other

Please note: Apple devices may cause login or course access issues — we recommend using a non-Apple device for the best experience.

I currently live in a:(Required)

How long have you lived where you are currently living?(Required)

I am under the age of 25 and have no prior rental history.(Required)

Yes

I have a large gap in my rental history.(Required)

Yes

I owe a previous landlord money.(Required)

Yes

I have bad landlord references.(Required)

Yes

I have an eviction on my record.(Required)

Yes

I have no credit or bad credit.(Required)

Yes

I have been denied before due to my criminal record.(Required)

Yes

I believe I have been denied housing before due to my race, ethnicity, or spoken language.(Required)

Yes

I believe I have been denied housing before due to my gender identity or sexual orientation(Required)

Yes

I am 16-27 and was under the jurisdiction of the juvenile court in the past 10 years.(Required)

Yes

Are you paying more than 1/3 of your monthly income towards rent/mortgage?

Yes

Are you currently being asked to leave your home and lack the resources to obtain other housing.(Required)

Yes

Will you have Section 8 or rental assistance when you look for your new place?

Yes

Are you on any Housing Authority waitlist(s)?

Yes

Do you receive any of the following sources of income? Know that you will need to provide verification by the end of this course.(Required)

Earned Income / Wages

TANF / AFDC

Child Support

Unemployment

SSI / SSDI

Pension

Worker's Comp.

WIC Benefits

SNAP / Food Stamps

Non-Cash Benefits

Other

I receive zero income or money from any source

Please enter the monthly amount for each of the above that you selected.

Earned Income / Wages

Please enter a number greater than or equal to 0.

TANF / AFDC

Please enter a number greater than or equal to 0.

Child Support

Please enter a number greater than or equal to 0.

Unemployment

Please enter a number greater than or equal to 0.

SSI / SSDI

Please enter a number greater than or equal to 0.

Pension

Please enter a number greater than or equal to 0.

Worker's Comp.

Please enter a number greater than or equal to 0.

WIC Benefits

Please enter a number greater than or equal to 0.

SNAP / Food Stamps

Please enter a number greater than or equal to 0.

Non-Cash Benefits

Please enter a number greater than or equal to 0.

Other

Please enter a number greater than or equal to 0.

Other

Please enter a number greater than or equal to 0.

Program Terms and Agreement(Required)

I understand this curriculum is for general educational use only and does not constitute legal advice. Further, it is not a substitute for the advice of an attorney. If you have a specific legal question, you should contact an attorney. This curriculum was written in October 2009 and updated in 2014, 2017, and 2019. While all reasonable efforts were made to provide accurate information in this curriculum, the City of Portland, Transition Projects, the Rent Well Program, and certified Rent Well instructors are not liable for any misinformation or outdated information presented in this curriculum.

Rent Well is a series of educational tools that helps landlords and tenants work together for stable, safe, and healthy rental housing. Rent Well and its educational materials and curriculum are registered trademarks of TRANSITION PROJECTS, INC., and therefore, I understand that I cannot use any of the materials or curriculum in whole or in part to recreate or reproduce without prior written consent.

I understand that while I may complete all the guidelines to graduate from the Rent Well tenant education course provided by TRANSITION PROJECTS, that there are additional requirements to access the landlord incentive fund beyond just my attendance and completion of the Rent Well course. To be eligible for the Rent Guarantee Program (RGP), I need to certify that my monthly income amount is at or less than 60% of median family income as defined by the current year’s income and rent limits of HOME and CDBG Grants (www.oregon.gov/ohcs/pages/research-income-rent-limits.aspx) and that I have barriers to obtaining permanent housing as identified on my student information form. I am providing my instructor, case manager, or/and their agency permission to provide the Rent Well, a program of Transition Projects, documentation of my eligibility for the Rent Guarantee Program (RGP). This verification includes, but is not limited to, a copy of a tenant education sample screen, debt collection letters, civil reports, police records, rental ledger, credit report, reference letters, case management notes, and/or copy of housing portfolio/ cover letter.

I understand this release is needed for the Rent Well Program to successfully register Landlord Incentive Funds, such as the Rent Guarantee Program, on my behalf. I give permission to review and verify my eligibility for the Rent Guarantee Program (RGP) with Oregon Housing and Community Services, the agency that oversees the RGP funding source, as well as with future landlords whom I wish to use my Rent Well certificate with for up to 18 months after my graduation date.

Once the certificate and Rent Guarantee Program are registered with my future landlord, I give the Rent Well permission to speak to my landlord for up to 13 months beyond the move-in date of my new tenancy. This communication will be regarding whether there is a need to use the RGP funding on my behalf if I move out in the first year of the tenancy and leave any unpaid rent, damages, or legal costs.

If this is not signed and access to the needed documents is denied, then the Landlord Incentive Fund cannot be registered, and I understand that I will be responsible for any and all debts related to my tenancy. I am giving consent voluntarily and understand that I may, at any time, revoke it in writing to the entity giving or receiving the information; however, such revocation will not apply to any information that has already been released. I have the right to see the information provided under this release at any time.

My authorization releases the Rent Well Program, Transition Projects, Oregon Housing and Community Services, and my landlord/property manager from any and all liability for damages arising from inquiring about, obtaining, providing, and/or taking action based on information covered by this release.

By entering or signing my name below, I certify, on this date, that the information that I have entered and attached to this form is true and correct to the best of my knowledge. I understand that providing false representations constitutes an act of fraud. Section 1001 of Title 18 of the U.S. Code makes it a criminal offense to make willful, false statements of misrepresentation to any department or agency of the United States or to any matter within its jurisdiction. Falsifying, concealing, or covering up by any trick, scheme, or device of a material or making any false fictitious or fraudulent statements or representations are subject to a maximum fine of $10,000 or imprisonment for not more than 5 years or both and may require the repayment of any or all funds received through the Rent Guarantee Program, liabilities and penalties under the U.S. Code or Oregon False Claims Act (ORS 180.750 to 180.785), and other remedies available under law.

I certify that I have read this release or have had it read to me, and I understand its content. I understand that I have a right to receive a copy of this release.

I have read and accept the Rent Well Program Terms and Agreement

Click here to open the Program Terms and Agreement in a new tab.

Note: If you’re not an Oregon resident, your application will be denied, but if you are planning to move to Oregon within the year, reach out to support@rentwell.org to appeal your application once submitted.

Welcome! Please complete the registration form below.

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Person 8

Please enter the monthly amount for each of the above that you selected.

Note: If you’re not an Oregon resident, your application will be denied, but if you are planning to move to Oregon within the year, reach out to support@rentwell.org to appeal your application once submitted.

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