First Time Homebuyers Workshop Registration

Date

Location

RENTAL INTAKE SHEET

Applicant Name

Last 4 of Social Security Number

Address

City

State

Postal Code

Telephone Number

Cell Phone Number

Email Address

Family Size

Monthly Rent

Income: (Please include unemployment, child support, alimony, social security, etc.)

Wage Earner 1 approx. gross monthly income:

Wage Earner 2 approx. gross monthly income:

How did you hear about this workshop?

Are you currently working with a down payment assistance program? If so, which one?

Are you currently working with a realtor or a bank/mortgage company? If so, which one?

Please select your choice:

I am

Single Married Divorced Separated Widowed

I am

Male Female

Ethnic Description

White Black or African American American Indian or Alaskan Native Asian Hispanic or Latino Other

Are you currently living in Section 8 or Government Housing?

Yes No

I am interested in getting help

Budgeting Credit Report Review Self Debt Repayment

When you plan to purchase a home?

Within 6months 7-12Months 1-2years

Applicant Signature

Note: If any problem after signing occurs, please click the blue button with red X to clear it and sign again.

Counseling Services and Disclosure Statement

I/We understand that it is my/our right and responsibility to decide whether to engage in any course of housing counseling with kingdom Community Development Corporation and to determine if counseling is suitable for my housing concerns.

I/We understand that I am not obligated to receive, purchase or utilize any other services offered by Kingdom Community Development Corporation, or its exclusive partners, in order to receive housing counseling.

I/We understand that Kingdom Community Development Corporation has the discretion to charge reasonable fees for counseling services, and that fees will be addressed prior to any counseling appointments. I further understand that no fee will be charged if it creates a financial hardship, nor will I be denied counseling if I cannot pay the fee.

I/We understand that Kingdom Community Development Corporation provides information on a broad range of housing programs and products and that the housing counseling received from Kingdom Community Development Corporation in no way obligates me to choose any particular loan product or housing program discussed in my counseling session.

I/We understand that Kingdom Community Development Corporation does not guarantee that I will receive mortgage financing from any lender and/or other mortgage financing entity. I/We understand that the counselor may answer questions and provide information but must refrain from giving legal advice.

I/We have read and understood the Kingdom Community Development Corporation counseling disclosure statement.

Applicant Signature

Counselor Signature

Telephone Counseling: Disclosure read to client?

Yes No

Pre-Purchase Homebuyer Education Services and Partnership Disclosure Form

Pre-Purchase Homebuyer Education may make you aware of products and/or services that we believe offer value to our clients. These products and/or services might be available directly from Housing Counselors, lenders, developers, or other agencies with which Credit Counseling has a working relationship. You are under no obligation to us, the products and/or services identified by Housing Counseling, whether by us or from industry partners.

Services provided by Agency:
DPC: Mortgage Delinquency and Default Resolution Counseling
PPF: Pre-Purchase Counseling
RHC: Rental Housing Counseling
FHW: Fair Housing Pre-Purchase Education Workshop
PPW: Pre-Purchase Homebuyer Education Workshops
RHW: Rental Housing Workshops

Applicant’s Printed Name

Applicant Signature

Co-Applicant’s Printed Name

Co-Applicant Signature

Counselor's Signature