Home Buyer Application

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Greater Rochester Habitat for Humanity
Homebuyer Program
Pre-Application

Please select a non-English language for viewing this form, if needed.

For which house are you applying?

If you want to apply for more than one house, you must complete a separate form for each desired house.

Primary Applicant

First Name

Last Name

Street Address

City

State

Enter 2-letter abbreviation (i.e. NY)

Zip Code

Phone

What is your birthdate?

MM/DD/YYYY

What is your Social Security Number?

Gender

Race

Ethnicity

Are you a U.S. citizen or legal resident?

Yes

What is your preferred language?

English

Spanish

Other

Please specify other language

Do you require a translator?

Yes

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Household

How many people are in your household?

Number of children under 18 in household

What is your total YEARLY household income before taxes?

Enter the estimated yearly income for ALL adults in the household that are not full-time students.

Enter numbers and decimal point only. No $ or comma.

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If you have a Co-Applicant, you must also provide information for your partner.
We will email them to have them verify the following information and co-sign the application.

Do you have a Co-Applicant?

Yes

Note: Co-applicants have equal rights to the property and are equally as liable for the mortgage.

Co-Applicant

Co-Applicant First Name

Co-Applicant Last Name

Same address as Primary Applicant

Co-Applicant Address

Co-Applicant Street Address

Co-Applicant City

Co-Applicant State

Enter 2-letter abbreviation (i.e. NY)

Co-Applicant Zip Code

Co-Applicant Phone

Co-Applicant Email

NOTE: an email will be sent to this address asking them to visit a link and verify the information you entered for them. They will add their birthdate and Social Security Number and they must sign and submit that form before your pre-application is considered complete.

Co-Applicant's Gender

Co-Applicant's Race

Co-Applicant's Ethnicity

Is Co-Applicant a U.S. citizen or legal resident?

Yes

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Below, click Save & Continue to submit this portion of your application.

After a short delay, you will be directed to two more screens:

The final question of the application
A screen where you will sign and submit.

Your application is not complete and will not be processed until you finish the final two steps.

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Greater Rochester Habitat for HumanityHomebuyer Program Pre-Application

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Greater Rochester Habitat for Humanity
Homebuyer Program
Pre-Application