Chelsea Restoration Corporation
1st Time Homebuyers Workshop Application
Date:
Name:
Current Address:
City:
State:
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Washington, D.C.
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Wyoming
Zip Code:
Telephone Number:
E-mail Address:
What Type of Property do you wish to purchase:
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Please select one
Condo
One Family
Two Family
Three Family
How many People live in your Household?
Yearly Gross Combined Income:
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Please select one
$10,000-$17,950
$17,951-$20,500
$20,501-$23,100
$23,101-$25,650
$25,651-$27,700
$27,701-$29,750
$29,751-$31,800
$31,801-$33,850
$33,851-$35,900
$35,901-$39,900
$39,901-$43,100
$43,101-$46,300
$46,301-$49,500
$49,501-$52,650
$52,651-Over
Race:
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Please select one
White
Black
Hispanic
Asian
Other
Elderly / Disabled:
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Please select one
Elderly
Disabled
Both
Male Head of Household:
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Please select one
Yes
No
Female Head of Household:
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Please select one
Yes
No
Certification
The applicant certifies that all information in this application is true to the best of his or her knowledge and belief, and no information has been omitted which might reasonably affect the judgment regarding the Homebuyers Counseling Program or any material changes in income or assets from the date of application, up to and until completion of the workshop. The applicant gives his or her permission to verify information provided from any source herein.
The applicant certifies that he or she has read all materials included with this application and has a basic understanding of the Homebuyer Counseling Program being offered.
Chelsea Restoration Corporation
Phone Number: 617.889.2277
Email:
info@chelsearestoration.org
Physical Address
154 Pearl Street
Chelsea, MA
02150
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