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Name  
Email  
Street Address  
City  
Province/State  
Postal/Zip Code  
Telephone  
Telephone (Other)  
Date of Birth     Year
Marital Status  
Occupation  
Residence  

Rent Own

How much rent do you pay?  
What percentage of your monthly income goes to rent?   %
     

Greatest obstacle to home ownership.

Please select all that may apply

  Lack of Savings
Lack of down payment
Low income
Below average credit
   
How would you rate your credit rating?   New
Bad
Average
Good
Excellent
     
Are you currently saving towards purchasing a home?   Yes No
     
If credit, income or down-payment were no object, would you consider buying a home?   Yes No
     
How soon do you see yourself buying a home?   Less than 1 year
1-2 years
3-5 years
Over 5 years
     
     
Given the opportunity, would you like to be part of a program that will enable you to own a home in less time, regardless of your credit, income or down payment?   Yes No
     
What is your home preference?   Condominium Apartment
Condominium Townhouse
Townhouse Freehold
Semi-Detach
Detach
     
Would you like to register and get the benefits you may be entitled to under the Canada-Ontario Affordable Index Plan (COAHIP)?   Yes No
 
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