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How to Apply

Pre-qualify Online Questionnaire

Do you have an interest in the West Pasco Habitat for Humanity's Home Ownership Program?

Please complete the pre-qualification form below to see if the West Pasco Habitat for Humanity's Home Ownership Program is right for you. Once submitted, someone from Habitat will contact you with the results and may invite you to complete a Home Ownership Program Application.

First Name
Middle Initial/Name
Last Name
*If not applicable write N/A
First Name
Middle Initial/Name
Last Name
*If not applicable write N/A
Country
Address Line 1
Address Line 2
City
State
Postal Code
Country
Address Line 1
Address Line 2
City
State
Postal Code
Have you lived or worked in West Pasco for at least one (1) year?:
Have you had varifiable and steady income for at least one (1) year?:
Have you or your co-applicant filed for bankruptcy in the last seven (7) years?:
Have you or your co-applicant had any repossession in the last seven (7) years?:
Have you or your co-applicant had any foreclosures in the last seven (7) years?:
Do you or your co-applicant have accounts in collection? (no not include medical):
If approved, how many ADULTS would be living in the Habitat home including you and your co-applicant?
#
If approved, how many MINORS would be living in the Habitat home including you and your co-applicant?
#
What is you and your co-applicant's total monthly income? Income sources include: Gross Wages, Social Security, Alimony, Child Support, Diability and any Other regular monthly income.
$
$
$
$
$
$
What is your total monthly debt? Only include: Mortgage Payment(s), Credit Card Payment(s), Alimony/Child Support Payment(s), Student Loan(s), Car Payment(s), Other loans such as: furniture. DO NOT INCLUDE: rent, utilities cell phone, tv and internet.
$
$
$
$
$
$
$
Are you willing to make a commitment to the Habitat program, which requires that homeowner candidates earn sweat-equity hours and attend a series of workshops?:
By signing and submitting this form, I affirm that the information on this form is true. I understand that providing false information could cause me to be disqualified from the Habitat program. I understand that someone from West Pasco Habitat for Humanity will contact me with the results from this questionnaire, and that I may be invited to complete a homeowner application.:
Applicant
First Name
Last Name
By signing and submitting this form, I affirm that the information on this form is true. I understand that providing false information could cause me to be disqualified from the Habitat program. I understand that someone from West Pasco Habitat for Humanity will contact me with the results from this questionnaire, and that I may be invited to complete a homeowner application.
Co-applicant
First Name
Last Name
*if not applicable write N/A

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