OPRHC West Cook Homeownership Programming Registration Form

The Oak Park Regional Housing Center

And the West Cook Homeownership HUD Program
Registration Form

Thank you for reaching out to Oak Park Regional Housing Center's West Cook Homeownership Program (WCHp), a HUD-approved, non-profit organization that offers FREE homebuyer education and counseling. Please complete this intake form to proceed with registration.

Gracias por comunicarse con West Cook Homeownership Center (WCHC), una organización sin fines de lucro certificada por HUD que ofrece asesoramiento GRATUITO. Complete este formulario de admisión para continuar con su registraccion.
Which of our programs are you interested in? If you are interested in registering for a second program, you will need to fill out and submit this form a second time to register.

Other
Which class are you interested in? If you are interested in registering for two classes, you will need to fill out and submit this form a second time to register.
If you are looking to purchasing a home, what is your time frame to do so? Si está pensando en comprar una casa, ¿cuál es su plazo para hacerlo?
Name / Nombre

First NameLast Name
Please Note: If someone is purchasing this home with you, they will need to complete this form separately as well.

Si alguien va a comprar esta casa con usted, también deberá completar este formulario por separado.
If someone else is buying this home with you, please provide their name. / Nombre del Co-Prestario.

First NameLast Name
Relationship to Applicant / Relación con el solicitante
Address / Dirección

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone / Teléfono

Area CodePhone Number
Email
example@example.com
Date of Birth / Fecha de nacimiento

MonthDayYear
Date
Gender identity / Identidad de género

Other
Ethnicity / Etnicidad
Race / la raza
Education / Educación

Other
Household Type:

Other
Are you an active military member? / Militar Activo?
Are you a Veteran?
Do you live in a Rural Area? / Vives en una zona rural?
Do you identify as a person with a disability? / ¿Te identificas como una persona con discapacidad?
Marital status / Estado civil
Type of employment / Tipo de empleo
Hire date / Fecha de contratación

MonthDayYear
Date
Please share your current annual household income / Ingreso anual del hogar
TOTAL Yearly Income of Household
How many people in your household?
How did you hear about us? / Fuente de referencia

Other
Check here is you would like to receive text SMS reminders/updates about your registered class or upcoming classes.
Disclosure

Oak Park Regional Housing Center, aka West Cook Homeownership Center is a nonprofit, HUD-approved, comprehensive housing counseling agency. We serve all clients regardless of income, race, color, religion/creed, sex, national origin, age, family status, disability, or sexual orientation/gender identity. We administer our programs in conformity with local, state, and federal anti-discrimination laws. As a housing counseling program participant, you are not obligated to use the products and services of West Cook Homeownership Center or our industry partners.

As a nonprofit organization, we require this information to complete your registration. This information will not be shared with anyone.

Due to our classes being held vitually, by submitting this form you approve your digital image to be seen on our virtual platform.
Signature
Should be Empty:

The Oak Park Regional Housing Center