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eligibility questionnaire

family of four smiling outside there home

    Please select the project which you are applying for *:

    Two-Bedroom Home, Midland (District of North Simcoe)

    Please note that we are not currently accepting applications for the following regions:
    District of Nipissing
    Sudbury District
    District of Cochrane

    Applicants Information

    Do you expect a change in your family size in the future? (eg. more children, children moving out, etc.)*

    YesNo

    I am a person who *:
    (please select all that apply)

    Is a young adult (under 30)

    Belongs to a racialized group

    Is a veteran

    Is Indigenous

    Is a senior citizen with mobility challenges

    Copes with a physical disability

    Copes with an intellectual disability

    Copes with mental health or addiction issues

    Identifies as LGBTQ2+

    Is a recent immigrant

    Is experiencing homelessness

    None of the above

    The Co-applicant and/or another live-in family member is a person who *:
    (Please select all that apply)

    Is a young adult (under 30)

    Belongs to a racialized group

    Is a veteran

    Is Indigenous

    Is a senior citizen with mobility challenges

    Copes with a physical disability

    Copes with an intellectual disability

    Copes with mental health or addiction issues

    Identifies as LGBTQ2+

    Is a recent immigrant

    Is experiencing homelessness

    None of the above

    My current home is *:
    (Please select one response)

    SuitableUnsuitable

    If 'unsuitable', Please check all that apply *:

    It is unaffordable. I currently spend more than 30% of my household income on housing.

    Click here to calculate percentage. This will open a new window.

    It is over-crowded. Too many people live in one room and privacy is greatly reduced.

    It is damp. It grows or has mould.

    It is draughty. It does not contain adequate heat.

    It is unsafe. It is in need of repair as a result of significant faults.

    Is a senior citizen with mobility challenges.

    It is unhygienic (dirty) and can't be cleaned.

    It has poor sanitation facilities, such as a toilet that doesn't work properly.

    It lacks cooking facilities. There is unsafe equipment, for example there's a gas leak or unsafe electrical connections to the cooker or microwave oven.

    It lacks suitable storage for food. The cupboards are damp; there is no refrigerator; or the refrigerator isn't working.

    It is too noisy due to excessive traffic or industrial activity in the neighborhood.

    It has poor access to shops and amenities.

    It does not have the accessibility features I need to cope with my mobility challenges and/ or physical disability.

    I don't have a home.

    Other.

    Please select one response for the following statements

    I have never owned a home before *

    AgreeDisagree

    I am committed to keeping a clean, organized, well-maintained home and know this is an important aspect of being a good neighbour.*
    AgreeDisagree

    I am willing to be an active participant in building a better home for my family and other families. *
    AgreeDisagree

    I am willing to support fundraising activities necessary to build a Habitat home. *
    AgreeDisagree

    I am willing to allow my family's story to be shared in order to raise awareness of the need for more safe, decent, and affordable housing. *
    AgreeDisagree

    I am willing and able to make affordable rent or mortgage payments. *
    AgreeDisagree

    I am willing and able to take on the responsibility of maintaining a home. *
    AgreeDisagree

    I am willing and able to be a good neighbour. *
    AgreeDisagree

    All applicants make all payments owing on time and have good credit history. *
    AgreeDisagree

    All applicants have never declared bankruptcy. *
    AgreeDisagree

    One of the applicants has declared bankruptcy in the past and the bankruptcy has been discharged. *
    AgreeDisagree

    One of the applicants has declared bankruptcy in the past and the bankruptcy is active or hasn't been discharged. *
    AgreeDisagree

    I understand that the homes built by Habitat for Humanity Ontario Gateway North are often constructed in part or in full by volunteers in the community. *
    AgreeDisagree

    I have never been charged with a criminal offense. *
    AgreeDisagree

    Thank you for your interest in being considered for a Habitat home. Please ensure all the information you entered is accurate and complete. We'll be reviewing your responses to determine eligibility for one of our affordable housing options.