Operated by Bowling Legacy LLC

Painted Lady Inn Room Application

A stability-focused, drug- and alcohol-free shared housing community.

The Painted Lady Inn is a drug- and alcohol-free home for people who need safe, stable housing, including people at risk of homelessness, people rebuilding from addiction, and people seeking a respectful community environment.

House rules are required for the safety and stability of all residents. Our primary rule is Unconditional Positive Regard for others. These questions help us understand housing needs, support needs, and whether this community is a good fit.

Applicant Information

Basic contact information for application review.

Full Name

Age

Phone Number

Email Address

Current Address

Housing Needs

Tell us what kind of housing support and room placement you need.

How long have you been at your current address?

Housing Need / Accessibility / Move-In Notes

Previous Housing / Shared Housing Experience

Reason for Leaving Previous Housing

Previous Evictions / Housing Barriers

Income & Stability

This helps determine whether the room is financially sustainable.

Monthly Income

Source(s) of Income

Employer / Program / Benefit Source Optional

How long has this income been stable?

Identification

Identification may be uploaded now or collected later during onboarding.

Driver License Number Optional

Oregon ID Number Optional

Upload ID Optional

I have a valid Oregon driver license or Oregon ID.

Health, Wellness & Community Fit

These questions help us understand support needs and community fit.

Do you now or have you in the past struggled with drug or alcohol addiction?

If yes, what support would help you rebuild stability?

Additional wellness, mobility, medical, or shared-living notes

Justice System Information

Parole, probation, pending court matters, or felony history do not automatically disqualify an applicant. This information helps us understand how best to support stability.

Currently on parole, probation, or involved in a pending case?

Have you served time with ODOC?

Officer / Contact Name Optional

Officer / Contact Phone Optional

Please explain anything we should understand

References Optional but Helpful

Reference 1 Name

Relationship

Phone

Reference 2 Name

Relationship

Phone

Program & Conduct Expectations

Painted Lady Inn maintains a drug- and alcohol-free environment with house rules, quiet expectations, respect for staff/residents/property, and cleanliness in shared spaces.

I understand and agree to comply with the drug- and alcohol-free housing environment and house rules.

I understand the primary house rule is Unconditional Positive Regard for others.

Applicant Certification

By submitting, I certify the information provided is true and complete to the best of my knowledge. I understand false information may result in denial of housing.