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Mariam Darsot
20th Annual Celebration

Non-Profit Organization

Language

Rental Application

Applicant

First name

Last name

Email

Adults (including you)

Housing Voucher?

Have you ever been evicted?

Phone

Children

Pets?

Desired move in date

Monthly Household Income

Current Address

Current Landlord Name

Current Landlord Phone

UMMA Center

221 Washington St.

Waukegan, IL 60085

Call us:

(847) 336-6136

UMMA Harvest Market

502 10th St.

Waukegan, IL 60085

Call us:

(224) 480-4320

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