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UNIVERSITY ASSISTED HOUSING PROGRAM - Application Form

This is the first step to complete for the University Assisted Housing program. Please answer the following questions. All information given is strictly confidential, and will be used by the Human Resources Department only to establish your eligibility to participate in the University’s assisted housing program.

Eligibility Application
* indicates required fields
* Full Name:
Current Address:		City/State:	Zip:
Home Number: Work Number: Cell Number:
* E-mail Address:
Work Location (Select One): Lake Shore Campus Water Tower Campus Health Sciences Campus		Hire Date:
Job Title:		Have you worked at Loyola continuously since hire date? Yes No
Are you a full-time, benefits eligible employee?:	Yes No
You are a	Faculty Staff
Number of persons in your household, including applicant(s): * Please fill out at least one person in this section.
Name	Age	Employer	Gross Annual Income
			$
			$
			$
			$
			$
Current Housing Situation: (check one)	I Own a Home	I Rent	I Live with Relatives or Friends
Would you consider moving within the community areas of the housing program?		Yes No
Which campus location are you looking to purchase your residence?		Lakeside Campuses Health Sciences Campus
Would you be interested in meeting with a housing counselor to talk about your financial situation and how to prepare to buy a condo or house?		Yes No
Would you be interested in participating in a home buyer education Seminar to learn about the home buying process and other similar programs?		Yes No
Can you afford to contribute $1,000 toward down payment for a home purchase?		Yes No
If you are currently in a contract, please list the property location:
If you are currently in the process of purchasing a home, please list your anticipated closing date:
Today's date: