Application

Chelsea First Time Homebuyers
Counseling Workshop Application

Date:
Name:
Current Address:
City:
State:
Zip Code:
Telephone Number:
E-mail Address:
What Type of Property do you wish to purchase:
How many People live in your Household?
Yearly Gross Combined Income:
Race:
Elderly / Disabled:
Male Head of Household:
Female Head of Household:

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.