UCHA Application Form

Application Form

Instructions:
  • Step 1 - Please fill-out the under mentioned information which will automatically be transferred into the official application form. Double check your information for accuracy before submitting Please also note the following:
    • Fields marked with an asterisk (*) are required.
    • Social Security # is required only if the Country of Birth or Citizenship is United States (USA).
  • Step 2 - Please print the PDF form, sign and date in all places where it states 'Signature and Date' before sending it to the UCHA.
  • Step 3 - Fax: 1-310-824-0112 or Email application to: ucha.director@gmail.com attached with clear copies of the following:
    • 1) Proof of student status, 2) a state ID/passport copy and 3) application fee/express fee payment.

Previous landlords in whose apartments you have lived within the last 3 years. Do not list relatives.

  Please ensure that you manually sign and date the Application Form (where it states 'Signature and Date'), before sending to the UCHA. If payment is made by credit card then sign and date in the required section as well.