Eligibility Criteria Form

Eligibility Questionnaire

Fill out our brief eligibility questionnaire below to help us determine if you meet the basic criteria to join our program.

Please note that completing this Eligibility Questionnaire does not guarantee a home or advancement to the next phase of our application process. Select homes have been delivered in part by CMHC’s federal funding for first-time homeowner Black families in the GTHA. Eligible applicants for these units must have at least one person in their household who identifies as Black.
Name*
Address*
City*
Province*
Postal Code*
Email*
example@example.com
Phone*
How many children, 16 years of age or under, will be living with you?*

12345+
Including yourself, how many people will be living in the home?*

123456+
What is your status in Canada?*

Canadian CitizenPermanent ResidentAn applicant for Permanent ResidentA refugee or refugee claimant - No immigration removal orders in placeFirst Nation status
Preference will be given to applicants who already work or live in the cities that we serve. Do you currently live and or work in any of the following communities?*

Halton Region: Including Oakville, Burlington, Milton, Halton Hills, etc.City of MississaugaDufferin County: Including Amaranth, East Garafraxa, Grand Valley, Mulmur, Mono, Melancthon, Orangeville, Shelburne, etc.Other
What is your current housing situation?*

RenterHomeownerLiving with Friends/Family in their homeLiving in temporary accommodations (shelter)Other
How long have you lived at your current address?*

Less than 1 year1-2 years3-5 years6 years or more
Does at least one adult in your household currently have full-time employment?*

YesNo
How long has this individual been working for their current employer?*

Less than 1 year1-2 years3-5 years6 years or more
What is your combined total annual household income? Please include the total income of all individuals over the age of 18, who are not full-time students.*

Less than $60,000$60,000 to $69,999$70,000 to $79,999$80,000 to $89,999$90,000 to $99,999$100,000 or more
What is your credit score?*

Below 660660 - 724725 or higherNot sure
Has any adult in the household ever declared bankruptcy?*

YesNo
If yes, when was it discharged?
Are you willing to be an ambassador for Habitat for Humanity HMD and share your story at public events, in media interviews or in videos?*

YesNo
Are you willing to contribute 500 volunteer hours to support Habitat's programs & services?*

YesNo
Are you willing to attend home maintenance and financial education workshops?*

YesNo
I understand that if I meet the initial screening criteria, I will be required to provide additional information. This information includes, but may not be limited to, proof of eligibility to work and reside in Canada, income and assets, credit history, criminal record checks, rental history, references, etc.*

YesNo
Select homes have been delivered in part by CMHC’s federal funding for first-time homeowner Black families in the GTHA. Is there at least one person in your household who identifies as Black?*

YesNo
I understand that completing this questionnaire does not guarantee a home or advancement to the next phase of our application process.*

YesNo
Thank you for your submission. You will receive an acknowledgement email within 2-3 business days. Only those applicants who meet all of the eligibility criteria for a specific project will be invited to the next phase of the selection process.
Should be Empty:

Eligibility Questionnaire