If you are interested in renting a room, we invite you to apply for our program!

Once you complete the online form below, your information will be sent directly to our team for review.

After submitting the form, you will receive a confirmation message that includes a "Download PDF" option. You may download the PDF at that time, and, if desired, save or print the document after opening it.

Any questions?
Need help with the application process? Email or call our team and we will be happy to assist you!

We Welcome Your Application
This program is not a financial assistance initiative; no funds are distributed to participants. Instead, Home Providers gain access to a pool of Renters who meet the program's criteria.

The Delaware Senior Home Shares staff offers administrative support to help match Home Providers with Renters.

If you’re seeking greater financial freedom and are looking for a home with available space for rent, we encourage you to apply to The Delaware Senior Home Shares.

We have Home Providers throughout Delaware.

Find a Home

Renter Application

The more questions that are completed, the stronger the match.

Questions with a * are required questions. All other questions are optional.

"*" indicates required fields

4. Are you Homeless?*
5. Address: Including Building/lot/apartment Number - Write Homeless if Applicable.*
8. Gender
9. Sexual Orientation
11. Date of Birth MM/DD/YYYY*
12. Race and Ethnicity
13. Veteran Status
14. Marital Status
15. Referral: How Did You Hear About Us?*
16. Do You Give Authorization to the De Senior Home Shares to Conduct a Background Check?*
20. Roommate Preferences:*
22. Renter Smoking Habits: Do You Smoke?*
23. Renter Alcohol Habits: Do You Drink Alcohol?*
25. Shared Services: Check Applicable Boxes if You Are Willing to Share Any of the Following Services With Your Host.
30. Renter Wishlist of Amenities*
31. Home Proximity
36. Declaration on Non-criminal History: Please Write Your Full Legal Name as an Electronic Signature to This Declaration.*
I (your name) declare as follows:
TRUE: I am an applicant for the The Delaware Senior Home Shares program.
TRUE: I have never been convicted of any felony or misdemeanor.
TRUE: I have never been on probation or parole.
TRUE: I declare under penalty of perjury that the foregoing is true and correct.
If any of the above are false for you, please write FALSE and explain conviction history. Please note that The Delaware Senior Home Shares is unable to accept persons on active parole.
37. Authorization to Release Information: Please Write Your Full Legal Name as an Electronic Signature to This Authorization. *

The Delaware Senior Home Shares program will verify information from an applicant as provided in the application and other documents required in connection with The Delaware Senior Home Shares program. The purpose is to identify program eligibility in addition to assisting personnel in effectively matching home hosts and renters for successful home sharing.

Please review the following procedures and statements:

I am considering application for participation in the The Delaware Senior Home Shares program. As part of the application process, I understand that Delaware Senior Home Shares may verify information contained in my application and other documents required.

I authorize contacts listed in my application to provide Delaware Senior Home Shares information. Such information includes, but is not limited to: three personal references (non-relative), including employment; employment history; residence; rental history; criminal history; and income sources. Public records may be used in this report, such as civil and court records.

A copy of this authorization may be accepted as an original.

This authorization will stay in effect for twenty-four (24) months / two (2) years from the date signed.

I agree that withholding any of the information requested in this document or submitting false information in connection with this document constitutes valid grounds for rejecting my application or termination of my HOME SHARE AGREEMENT.

By signing below, I certify that I have read this document carefully, understand it, and agree to it voluntarily and without duress.
38. Permission for Use of Photographs*
After submitting the form, you will receive a confirmation message that includes a "Download PDF" option. You may download the PDF at that time, and, if desired, save or print the document after opening it. Thank you again for your participation in the application process and for your interest in Delaware Senior Home Shares.
This field is for validation purposes and should be left unchanged.