fort wayne habitat

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Volunteer

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Donate

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Restore

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Prequalify
Have you lived or worked in Allen County for the last twelve months?
Yes
No
Applicant Name
Address
Apt #
City
State
Zip
Date of Birth
Social Security Number
Home Phone
Work Phone
Cell Phone
Marital Status
Married
Separated
Unmarried
Applicant's Employer
How long have you worked here?
Start date
End date
How are you paid?
Hourly
Not Hourly
Previous Employer (required if not employed at current job for at least two years)
How long did you work here?
Start date
End date
How were you paid?
Hourly
Not Hourly
Do you receive child support?
Yes
No

Please list below monthly income the applicant receives other than their main job and child support.

Supplemental Security Income (SSI)
Social Security
Disability
Second Job

Is there a second applicant?

Yes
No

How many other persons will be living with you, including children?

0
1
2
3
4
5
6
7
8

Please answer the following questions.

General Eligibility

Have you lived or worked in Allen County for the last twelve months?
Applicant
Yes
No
Co-Applicant
Yes
No
Have you or someone you were/are married to owned a home in the last three years?
Applicant
Yes
No
Co-Applicant
Yes
No
Do you have a bankruptcy that has not been discharged/dismissed for three years?
Applicant
Yes
No
Co-Applicant
Yes
No
Do you have deferred student loans?
Applicant
Yes
No
Co-Applicant
Yes
No
If you PAY child support to someone else, please list the monthly payment.
Applicant
$
Co-Applicant
$
If you have a car payment, please list the monthly payment.
Applicant
$
Co-Applicant
$

Housing Need

What is your current monthly rent payment?
$
Do you live in public housing?
Yes
No
Do you receive Section 8 rental assistance?
Yes
No

Willingness to Partner

Are you willing to contribute 300 "sweat equity" hours by attending homeownership classes, volunteering at the ReStore and working on the construction site?
Yes
No
Are you willing to save at least $500 for a down payment on a home?
Yes
No
Are you willing to take a home in any location Habitat has available in the county?
Yes
No
How did you hear about the Habitat for Humanity program?
Friend/Family
Internet - (please list site)
Habitat Homeowner - Who?
TV
Newspaper
Billboard
Radio
Another Agency (please list agency name)
Other - Where?

Race/National Origin

Hispanic
Caucasian
Black/African American
Asian
Burmese
American Indian or Alaskan Native
Native Hawaiian or Other Pacific Islander
Other (please specify)
Do not wish to answer
Facts WHAT DOES FORT WAYNE HABITAT FOR HUMANITY, INC. DO WITH YOUR PERSONAL INFORMATION?
Why? Financial companies choose how they share your personal information. Federal law gives consumers the right to limit some but not all sharing. Federal law also requires us to tell you how we collect, share, and protect your personal information. Please read this notice carefully to understand what we do.
What? The types of personal information we collect and share depend on the product or service you have with us. This information can include:
  • Social security number and income
  • employment information
  • credit history and credit card or other debt information.
When you are no longer our customer, we continue to share your information as described in this notice.
How? All financial companies need to share customers' personal information to run their everyday business. In the section below, we list the reasons financial companies can share their customers' personal information: the reasons Fort Wayne Habitat for Humanity, Inc. chooses to share; and whether you can limit this sharing.
Reasons we can share your personal information Does FWHFH share? Can you limit sharing?
For our everyday business purposes -
such as to process your transactions, maintain your account(s), respond to court orders and legal investigations, or report to credit bureaus		 Yes No
For our marketing purposes -
to offer our products and services to you		 No We do not share
For joint marketing with other financial companies No We do not share
For our affiliates' everyday business purposes -
Information about your transactions and experiences		 No We do not share
For our affiliates' everyday business purposes -
Information about your creditworthiness		 No We do not share
For non-affiliates to market to you No We do not share
Questions? Call 260-422-4828 or go to https://fortwaynehabitat.org
Who we are
Who is providing this notice? Fort Wayne Habitat for Humanity, Inc.
What we do
How does Fort Wayne Habitat for Humanity, Inc. protect my personal information? To protect your personal information from unauthorized access and use, we use security measures that comply with federal law. These measures include computer safeguards and secured files and buildings.
How does Fort Wayne Habitat for Humanity, Inc. collect my personal information? We collect your personal information, for example, when you
  • Give us you income information
  • Provide employment information
  • Apply for financing
  • Give us your contact information
  • Pay us by check
We also collect your personal information from others, such as credit bureaus, affiliates, or other companies.
Why can't I limit ALL sharing? Federal law gives you the right to limit only
  • sharing for affiliates' everyday business purposes- information about your creditworthiness
  • affiliates from using your information to market to you
  • sharing for non-affiliates to market to you
State laws and individual companies may give you additional rights to limit sharing.
Definitions
Affiliates Companies related by common ownership or control. They can be financial and nonfinancial companies.
  • Fort Wayne Habitat for Humanity, Inc. has no affiliates.
Nonaffiliates Companies not related by common ownership or control. They can be financial and nonfinancial companies.
  • Fort Wayne Habitat for Humanity, Inc. does not share with nonaffiliates so they can market to you.
Joint marketing A formal agreement between nonaffiliated financial companies that together market financial products or services to you.
  • Fort Wayne Habitat for Humanity, Inc. does not jointly market.
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