Interest Form

This form is only for applicants who reside in Lucas County, Ohio.

Please review the Apply for a Home web page to ensure you meet our guidelines before submitting this form to MVHFH. Please note that this Interest Form is NOT an application for a Habitat home, but provides us with your contact information so that we can forward a Pre-Application form to you. NOTE: If your income is less than $1,886 per month - you can not apply at this time. Minimum income ranges are required in order to apply. If you have gone through bankruptcy in the past 2 years you can not apply at this time. You must wait until two years after discharge of a bankruptcy. In the event you cannot apply at this time, please try again when your situation improves.

REQUIREMENTS

*1) Is your gross income (before taxes) $1,886.00 per month or more?

Yes

*2) What is your need for a home?

Overcrowding

Poorly Maintained

Dangerous Neighborhood

In temporary living arrangement

Other (use box below)

Other:

*3) Are you willing to partner with Habitat?
This requires 300-500 "Sweat Equity" volunteer hours. There are various volunteer opportunities with Habitat and other organizations. It includes working on building homes for other Habitat families and yourself, attending budget classes and attending monthly meetings.:

Yes

4) How did you hear about us?

YOUR INFORMATION *First Name:
*Last Name:
*Address:
*City:
*State:
*Zip:
Email Address:
Home Phone:
Cell Phone:
Work Phone: