River City Habitat for Humanity Interest Form
Please fill out this form in order to be contacted when we are accepting applications for our Home Ownership Program
Name *
Email *
Street Address *
City *
State *
Zip Code *
Phone number *
Number of Adults in the Household *
Number of Children in the Household *
Thank you for your interest in partnership with River City Habitat for Humanity!
If your contact information changes, you MUST contact our office to update it!

Please keep in mind some of our guidelines:
 Must live or work in Cole County
 Must be legal residents of the United States.
 Applicants must have a gross family income of at 30% but no more than 60% of the median income of Cole County (see separate sheet on our website for details or call 573-635-8439).
 Two years must have passed since a bankruptcy has been discharged.
 Applicants must pass a background check showing that no one in the home has been convicted of a felony in the past 10 years and that no one is currently on the sex offender registry list.
 Applicants must not have had a home foreclosure in the past 3 years.

Please note this is NOT an application into our program. By completing this form, it allows us to contact you when we are selecting new homeowners and invite you to a Homeowner’s Basic Class to learn more about the program. At that point, you will be able to fill out an application if you are interested. On average, please note that the wait can be up to 6 or more months between selection cycles.

River City Habitat for Humanity
1420 Creek Trail Drive, Jefferson City, MO 65109
www.rivercityhabitat.org
(573) 635-8439
info@rivercityhabitat.org

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