HfHYC home
A house is made of walls and beams;
a home is built with love and dreams.


Family Information Form
The foundation of the Habitat mission is partnering with families, working side by side with them as they help build their homes. A huge part of this partnership is “sweat equity” or volunteer time. Each family must be willing and able to put in 400 hours of volunteer time. Total income must be within the following ranges to be eligible for a HFHYC home:

Family Income
Total Family Members 1 2 3 4 5 6 7 8
Low Income $30,000 $30,000 $30,000 $30,000 $30,000 $32,580 $36,730 $40,890
High Income $35,400 $40,440 $45,480 $50,520 $54,600 $58,620 $62,700 $66,720

FAMILY QUESTIONNAIRE

Personal Information First Name: Last Name: Date:

Birth Date: Email:

Address:

City: State: Zip Code:

Phone: Cell Phone:
Contact me by:

Are you a veteran?:
Is Your spouse a veteran?:


Please provide us with information about your family.

Pleas provide your family's total annual income: $

List all Family Members who would are living in the Home:

Person Relationship Age

Person Relationship Age

Person Relationship

Person Relationship Age

Person Relationship Age

Person Relationship Age

Person Relationship Age

Have you read the requirements for Habitat for Humanity York County Home Ownership?
For more information go to the Home Ownership Page or call (207) 985-4850.

How would you and your family fulfil their "sweat equity hours"?

Why would you like to own a Habitat home?

Please give us a brief synopsis of your current living arrangements.


Has anyone in your household ever declared bankruptcy?
If so, please explain (year, circumstances, where)


Has anyone in your household ever had a criminal conviction?
If so, please explain:


How did you learn about Habitat for Humanity York County?

Comments:


Thank you for your interest in applying for a Habitat for Humanity York County home.
Please print this form and mail it to Habitat for Humanity at the above address or
click the SEND button to submit the information to Habitat for Humanity York County.