Name *
Date of Birth
Date of Birth
Phone *
examples: she/her/hers, they/them/theirs
Have you ever been convicted of a gross misdemeanor or felony? *
An affirmative answer will not automatically disqualify you from being considered for housing.
Do you plan on bringing any pets? *
Do you plan on bringing a car? *
Do you plan on bringing a bike? *
Do you use alcohol? *
Do you smoke? *
How do you plan on paying your monthly membership dues? (check all that apply) *
Have you ever lived in a cooperative before? *
Have you ever rented before? *
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?