Express Interest Please complete this form so that we can schedule a call to discuss your interest in our neuro-inclusive cohousing program. Step 1 of 4 25% Contact InformationName(Required) First Last Email(Required) Enter Email Confirm Email PhoneHow would you describe yourself?(Required)Select the most appropriate answerNeurotypicalNeurodiverseOtherPlease describe your choice of 'other' Resident DetailsName(Required) First Last Sexual Orientation(Required)Please chooseMaleFemaleChoose not to answerPreferred gender pronoun(Required)Please chooseHe/HimShe/HerSomething elseChoose not to answerAge(Required) Primary IDD(Required)Select OnePlease select the most appropriate answerAutism Spectrum DisorderDown SyndromeNeuro-typicalCerebral palsyFragile X syndromeOther - Please describePlease select the best option. Primary IDD Other Please describe your answer of other IDDThe resident's support needs are best described as...(Required)Please select the most appropriate answerNo Support – The resident independently can live alone and preform all activities of daily living without Direct Support Professional support.Drop-in – The Resident needs a DSP to check in with them every few days or as requested; the individual is self-sufficient the majority of the time.Low – The resident needs a DSP to support them with a few tasks each day but can be self-sufficient for most of the day.Moderate – The resident needs a DSP periodically throughout each day but can be self-sufficient for several hours at a time.24/7 – The resident needs access to a DSP at all times but the DSP may be shared with others; they are not the only person receiving support from the DSP the majority of the time.Daily medical support - The resident needs the attention of a medically trained/certified provider to safely complete daily routine care, such as assistance with eating, breathing (including durable medical equipment), etc.Memory care - Due to symptoms of dementia or Alzheimer’s disease, the resident needs a safe environment, with extra structure and support to navigate the dayOne-to-one - The resident needs the full attention and in-person support of at least one DSP at all timesHigh behavioral support - The resident needs specialized support(s) to mediate severe challenging behavior, significant adaptive skill deficits and medical/ behavioral issues to participate safely in home and community life.The resident identifies as Neuro-typical with no support needs. Coliving (Phase 1) vs. Cohousing (Phase 2)Cohousing is an intentional community of private homes clustered around shared space. Each home has traditional amenities, including a private kitchen. Shared spaces typically feature a common house, which may include a large kitchen and dining area, laundry, and recreational spaces. Shared outdoor space may include parking, walkways, open spaces, and gardens. Households have independent incomes and private lives, but neighbors collaboratively plan and manage community activities and shared spaces. Coliving is similar, but all the people are living under one roof/a single-family home.I am interested in the following type of community(Required)Please select one.Please select the most appropriate answerCohousing (Phase 2)Coliving (Phase 1)OtherOther type of community Please describe your choice of other type of communityWhich county would the resident/applicant prefer to live in?(Required)Please select one.Please select the most appropriate answerBucks CountyMontgomery CountyLehigh CountyNorthampton CountyOtherOther Counties of Interest Please describe which other Counties are of interest to you or the resident/applicant Acknowledgment & ConsentThis document is non-binding. By completing and signing, it does not bind me to accept nor FPC to offer acceptance into their program. I will complete the Front Porch Cohousing application process at the appropriate time to determine if I or my dependent is eligible to live in the community.Consent(Required) By checking this box and entering my initials below, I warrant that I possess all the rights, powers, and privileges of a parent, legal guardian, or potential resident necessary to submit this document.Today's Date(Required) MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged. Δ