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Homeownership Workshops
Sweat Equity - #145
Sweat Equity- ReStore

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Contact information

First name

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Last name

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Phone

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Email address

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Date of birth

Month

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Day

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Year

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Background

Gender

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Ethnicity

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Education

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Languages

Address

Address

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Apartment, suite, etc. (optional)
City

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Country/region

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State

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ZIP code

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Experience

Skills
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Additional details

T-Shirt size

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Dietary restriction
Allergies
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The following questions are mandatory and will help provide insight into the experiences and needs of families seeking affordable and stable housing opportunities in the Quad Cities and help Habitat QC better understand how we can help serve our community.  Thank you for your responses.

What is your age range?

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What is your gender identity?

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What is your racial or ethnic background?

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What is your current relationship status?

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How many people currently live in your household?

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How many children live in your household?

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What is your highest level of education completed?

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What is your current employment status?

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Where do you currently work?

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Approximately how long have you lived in your current community / town?

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What are some strengths or values that have helped your family through difficult times?

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What support systems do you currently have?

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List any religious or community organizations you are a part of.

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Were you born in the Quad Cities?

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If your answer was NO: Where are you born?

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If your answer to #14 was NO: Why did you move to the Quad Cities?

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If your answer to #14 was NO: When did you move to the Quad Cities?

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What type of housing were you living in when you applied for Habitat for Humanity QC homeownership program?

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If you are renting, when do you need to renew your lease?

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Have you experienced housing instability in the last year? (Housing instability refers to any number of housing challenges such as trouble paying rent, frequent moving, running out of space / overcrowding, spending most of your income on housing)

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If your answer to the above was Yes, how long had you experienced housing instability before applying?

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Which housing challenges influenced your decision to apply?

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On a scale from 1- 5, how stressful was your housing situation? (1= Not Stressed, 5 = Extremely Stressed)

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Did your housing situation affect any of the following?

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Emergency contact

Relationship

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First name

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Last name

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Phone

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Phone type
Email address

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Email type

Confirmation

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