Homeownership Readiness - Inquiry List
First Name
Last Name
E-mail Address
Cell Phone Number
Other Phone Number
Street Address
City
State
Please select...
Iowa
ZIP Code
Preferred meeting time
Mornings (8:00 to 12:00)
Afternoons (12:00 to 4:00)
Morning or Afternoon
Do you have preferred days to meet?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
County of Residence
Please select...
Polk County
Dallas County
Jasper County
Warren County
Please note
: If you do not live or wish to live in Polk, Dallas, Jasper, or Warren County,
Iowa
, please click
HERE
to find the Habitat for Humanity affiliate that serves your area!
You have selected
Polk County, Iowa
. Greater Des Moines Habitat for Humanity only serves Polk, Dallas, and Jasper counties in central Iowa. Please click, "Yes" the check box to confirm that you are interested in continuing.
Please select...
Yes
No - Please do not add me to the interest list
You have selected
Dallas County, Iowa
. Greater Des Moines Habitat for Humanity only serves Polk, Dallas, Jasper, and Warren counties in central Iowa. Please click, "Yes" the check box to confirm that you are interested in continuing.
Please select...
Yes
No - Please do not add me to the interest list
You have selected
Jasper County, Iowa
. Greater Des Moines Habitat for Humanity only serves Polk, Dallas, Jasper, and Warren counties in central Iowa. Please click, "Yes" the check box to confirm that you are interested in continuing.
Please select...
Yes
No - Please do not add me to the interest list
You have selected
Warren County, Iowa
. Greater Des Moines Habitat for Humanity only serves Polk, Dallas, Jasper, and Warren counties in central Iowa. Please click, "Yes" the check box to confirm that you are interested in continuing.
Please select...
Yes
No - Please do not add me to the interest list
Will another adult be applying for a home loan with you?
Please select...
Yes
No
Which city or town do you currently work in?
Do you have children in your household who are in Kindergarten through 12th grade?
Please select...
Yes
No
Which school district are they enrolled in?
Please select...
Adel-DeSoto-Minburn Community School District
Ankeny School District
Baxter School District
Bondurant-Farrar School District
Colfax-Mingo School District
Dallas Center-Grimes School District
Des Moines Independent School District
Johnston School District
Lynnville-Sully School District
Newton School District
North Polk School District
PCM School District
Perry School District
Saydel School District
Southeast Polk School District
Urbandale School District
Van Meter School District
Waukee School District
West Des Moines School District
Woodward-Granger School District
Home Schooled
Private School
Preferred Method of Contact
Please select...
Email
Phone
Text
USPS Mail
In-Person
No Preference
Primary Language
Please select...
Amharic
Arabic
Armenian
ASL
Bosnian
Burmese
Cambodian
Chin
Chinese - Cantonese
Chinese - Mandarin
Czech
English
French
French Creole
German
Greek
Gujarati
Hindi
Hmong
Indonesian
Italian
Japanese
Karen
Kirundi
Korean
Kunama
Nepali
Nuer
Other
Persian
Polish
Portuguese
Russian
Somali
Spanish
Swahili
Tagalog
Tigrinya
Turkish
Ukrainian
Urdu
Vietnamese
Do you need an interpreter?
Please select...
Yes
No
Race (optional)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Pacific Islander
White
Please select all that apply
Ethnicity (optional)
Hispanic or Latino
Not Hispanic or Latino
Are there any active duty service members or veterans living in your household?
Please select...
No, no one in my household has military experience
Yes, Active Duty
Yes, Veteran
Are there any individuals who have special needs or need accommodations living in your home?
Please select...
Yes
No
How did you hear about us?
Please select...
DART bus advertising
Friends or Family
Google or other search engine
Internet advertising
Mailer
Newspaper
Radio
TV
Social Media (Facebook, Instagram, X, etc.)
Other advertising
Other
Greater Des Moines Habitat for Humanity may need to contact you regarding your response. We require your consent to contact you by phone, text message, and/or email. By confirming below, you agree and opt in to be contacted by Greater Des Moines Habitat for Humanity.
You have the ability to opt out of text messages at any time. Standard text message rates apply. To review our privacy policy, click
here
. To review our terms of use, click
here
.
Yes, I give my consent to be contacted by Greater Des Moines Habitat for Humanity
No, I do not consent to be contacted by Greater Des Moines Habitat for Humanity
Greater Des Moines Habitat for Humanity's Homeownership Program does not serve any household that has a registered sex offender and that finding any household member on a sex offender registry is grounds for immediate disqualification from service.
Check, if you acknowledge and agree to abide by GDM Habitat's Sex Offender policy
Do you currently own a home?
Yes
No
Unsure
Have you owned a home in the past three years?
Yes
No
Unsure
Have you filed for bankruptcy within the last year?
Yes
No
Unsure
How many people live in your household?
What is your yearly income before taxes, for anyone who would be paying for the house?
$0.00 - $20,000
$20,000-39,000
$39,000 - $65,000
$65,000 - $75,000
$75,000 - $90,000
$90,000 - $105,000
$105,000+
What is your yearly income before taxes, for for all adults in the household?
$0.00 - $20,000
$20,000-39,000
$39,000 - $65,000
$65,000 - $75,000
$75,000 - $90,000
$90,000 - $105,000
$105,000+
I understand that, if my application is accepted, GDM Habitat's Homeownership Program takes 9-12 months. There are limited opportunities to buy in less time.
I understand
I understand that GDM Habitat requires applicants to have a residency status of Permanent Resident or US Citizen to qualify for the Homeownership Program.
I understand
Contact Information