Date of Birth
Date of Birth
Which KCH home would you prefer?
Fletcher (8 bedroom group co-op)
Meristem (6 bedroom group co-op)
1 bedroom apartment
2 bedroom apartment
3 bedroom apartment
If yes, please specify
When do you plan to move in?
If so, what kinds?
What is your food preference?
Any medical needs that your housemates should be aware of?
If yes, when?
If yes, where?
Every year, KCH must certify that our membership is composed of at least 75% low-income people and 20% very low-income people (according to the US Department of Housing and Urban Development). Low-income individuals receive no more than 80% of Kalamazoo’s median income ($34,650/year), and very low-income individuals receive no more than 50% of Kalamazoo’s median income ($21,650/year). Please calculate your income for the most recently completed calendar year, including total wages, salaries, tips, bonuses, commissions, self-employment income, interest, dividends, investments, scholarships, grants, regular support from parents or family, and other income sources.
How much do you earn every year?
Less than $21,650
Between $21,650 and $34,650
More than $34,650
Please describe yourself (studies, jobs, organizations, hobbies, interests, goals, background, etc.).
Why are you interested in living in a cooperative?
How did you hear about KCH (if referred by somebody, who?)