Greater Rochester Habitat for Humanity

Pre-Application

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

AMI from Calculator

HH Size from Calculator

Neighborhood:

I am interested in learning whether I qualify for a home in Geneva, NY

Primary Applicant

First Name

Last Name

Street Address

City

State

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

Zip Code

Best phone number to reach you

Phone Type

Cell

Home

Work

Email

What is your birthdate?

MM/DD/YYYY

What is your Social Security Number?

Gender

Race

Ethnicity

Hispanic Type

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

Yes

No

What is your preferred language?

English

Spanish

Other

Please specify other language

Do you want assistance in another language?

Yes

No

What level of education have you completed?

Page 2

Household

What is your total YEARLY household income before taxes?

How many people are in your household?

Number of children under 18 in household

SORRY!
Your income is lower than the minimum requirement of $54,982 for our upcoming Geneva project. You cannot submit an application with the yearly household income you have entered.

SORRY!
Your income is higher than the maximum allowed Average Median Income (AMI) of 80% for our upcoming Geneva project. You cannot submit an application with the yearly household income you have entered.

SORRY!
Your household size is too large for the homes we are planning to build at this time. You cannot submit an application now. Please click this link to join our mailing list to be notified the next time we are accepting applications.

Page 3

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

No

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

Best phone number to reach co-applicant

Phone Type

Cell

Home

Work

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

Hispanic Type

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

Yes

No

Page 4

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.