Habitat for Humanity Northwoods Inquiry Form

Name

Phone at home

Phone at work

Please tell us what you now pay for housing each month

Every Habitat couple or family with two parents must work at least 500 hours and each single parent or single person, 250 hours before closing on the family home. Your friends and family can help.
Will you be able to do this

Yes

Boys

Girls

Have you lived in Oneida or Vilas County for a year or more?

Yes

Do you have a Tribal, NEWCAP or a HUD subsidy now?

If the home you are living in now is in an unsafe area or has plumbing problems, an inadequate heating system, a leaky roof or some other problem which makes it unsafe for you and your family, please tell us about these problems.
This question is essential. Please provide as much information as possible.

Have you filed for or have you been granted bankruptcy in the past 12 months?

Address

City

Zip Code

Please tell us your yearly income, including Social Security income

How many children under 18 live with you full time?

How many adults, 18 or older, live at your home all the time?
Include yourself, your partner, adult children and other relatives.

How many bedrooms do you now have?

Yes

We will let you know quickly if you are eligible to receive a full application. We hope so. If you would like to talk to a Habitat family or a Habitat volunteer please call the office at 715- 356-7203

Revised November 2004

HABITAT FOR HUMANITY NORTHWOODS

Inquiry Form

We hope we will be able to work with you on a Habitat home. Each Habitat homeowner must have a need for housing, be able to afford mortgage payments, insurance and taxes and be willing to work with other Habitat volunteers building homes.

1) Please click herer to read the Supplemental Information for the Inquiry Form to help you understand Habitat requirements.

2) Please answer the questions on this form. You can either print the form and send it to the Habitat office
(the address is at the bottom of the page) or simply click the submit buttom to email the completed form to the Habitat office.

All your information is confidential.

Directions

Habitat for Humanity Northwoods Wiscinsin, Inc.
P.O. Box 552
Minocqua, WI 54548

Or print and mail form to: