Affordable Housing Survey
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Housing Needs and Eligibility
I am interest in:
*
BUYING an affordable home
RENTING an affordable home
EITHER BUYING OR RENTING an affordable home
NOT LOOKING TO MOVE
Tell us about your current housing. I currently:
rent a home, apartment or room
own a home
live with friends/family
do not have a place to live
TOP 3 MOST IMPORTANT THINGS ABOUT MY HOME from the list below:
Close to work or school
Close to services (grocery, doctor, shopping)
On-site amenities (pool, dog park)
Close to transit (bus, light rail)
Safe neighborhood, low crime rate
Do you feel that your current housing is affordable for your budget?
Yes
No
Unsure
How much a month do you spend on housing (rent or mortgage)?
How many people are in your household?
1 person
2 persons
3 persons
4 persons
5 persons
6 persons
What is your total household income before taxes (GROSS ANNUAL INCOME)?
0-$30,000
$30,001-$50,000
$50,001-$60,000
$60,001-$70,000
$70,001-$80,000
$80,001-$90,000
$90,000-$100,000
$110,000-$120,000
$120,000 +
Submit
Name
*
First Name
Last Name
Should be Empty: