Preferred Name
First Name
Last Name
Legal Name
*
First Name
Last Name
Date of Birth
MM
DD
YYYY
Phone
*
(###)
###
####
Email
*
Current Address
*
City
*
State
*
When do you plan to move in?
*
Do you plan on bringing any pets?
*
If so, what kinds?
Do you plan on bringing a car?
*
Do you plan on bringing a bike?
*
Do you use alcohol?
*
Do you smoke?
*
What is your food preference?
*
Omnivorous
Vegetarian
Vegan
Other
Do you have any medical needs that your housemates should be aware of?
*
How do you plan on paying your monthly membership dues? (check all that apply)
*
If "other" please specify
Check all that apply
*
Have you ever lived in a cooperative before?
*
If yes, when?
If yes, where?
Have you ever rented before?
*
Landlord Name
Landlord Address
Landlord Phone
Landlord Name
Landlord Address
Landlord Phone
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?
What house/collectives are you applying for?
*
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?)
*
Your application has been received. It will be directed to the collectives that you have applied to for review. If they decide to move forward with your application, they will be in contact with you directly. Thank you!
