Be a Homeowner -- Turning hope into homes

Habitat for Humanity of Prairie Lakes

Pre-application

To find out if you might qualify to own a Habitat for Humanity of Prairie Lakes home, please answer the questions that follow and return the completed form to the address below within one week. Your information will be reviewed, and you will be contacted by a Habitat for Humanity family selection team representative.

Applicant’s legal name (please print)

Co-applicant’s legal name (please print)

Address (street)

(city, state, ZIP) email: ______

Phones: daytime ______evening ______cell ______

If approved, how many people would be living in the house? adult(s) and _____ children

I. Applicant’s gross income from work: $ ______per £ week £ 2 weeks £ month

Disability benefit $______per month / MFIP $______per month
SSI $______per month / Child support $______per month
Other income $______per month

Co-applicant’s gross income from work: $ ______per £ week £ 2 weeks £ month

Disability benefit $______per month / MFIP $______per month
SSI $______per month / Child support $______per month
Other income $______per month

Have you ever filed bankruptcy? £ Yes £ No If “yes,” when was it discharged?

Are there any legal judgments against you? £ Yes £ No If “yes,” total amount: $

II. Describe concerns with your current housing situation.

______

III. Do you currently rent or own? ______

IV. Are you willing to partner with Habitat for Humanity? £ Yes £ No

V. Are you willing to live in Pope County, Minnesota? £ Yes £ No

Mail this Pre-application form to: For assistance, please call: 320-634-0355

Habitat for Humanity of Prairie Lakes

P. O. Box 122

Glenwood, MN 56334

Habitat for Humanity of Prairie Lakes, a Christian organization,
builds simple, decent and affordable houses through the efforts of partner families, donors, and volunteers.

pre application form – Prairie Lakes.docx