Client Interest Form
Program Interest
Please select...
Annual Re-Certification
Eviction Prevention
Financial Counseling
First Time Home Buyer
Foreclosure Prevention
Home Buyer Grant
Senior Home Repair
First Name
Middle Name
Last Name
Street Address
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Email
Mobile Phone
OK to share contact info?
Please select...
Yes
No
Co-Borrower Information
I have a co-borrower
First Name
Last Name
Mobile Phone
Email
What race and/or ethnicity do you identify with?
Please select...
American Indian/Alaskan Native
Asian
Black or African American
Multi Racial
Native Hawaiian or Other Pacific Islander
White
Other
Prefer not to say
Do you have Hispanic or Latino origin?
Please select...
Hispanic
Not Hispanic
Prefer not to say
What are your pronouns?
Please select...
She/Her
He/Him
They/Them
She/They
He/They
Other
Other pronouns
Highest level of education
Please select...
GED
Some High School
PHD or Higher
Bachelor's Degree
Masters Degree
High School
Associates Degree
Some Graduate School
How did you hear about Dundalk Renaissance?
Please select...
Baltimore County Resources
Community Assistance Network
DRC Newsletter
DRC website
Eagle Ad
Facebook
Housing Counseling Agency
Instagram
Lender
Maryland Government Resources
Personal Network
Realtor
TikTok
YouTube
By whom?
How many people, including children, are in your home?
What is the borrower(s) gross income?
Home Buyer Grant / First Time Home Buyer Interest
Why are you interested in buying a home in Dundalk?
What steps have you taken so far towards homeownership?
What has been your greatest challenge to becoming a homeowner?
Are you working with a Realtor?
Please select...
Yes
No
Realtor Name
Are you working with a Lender?
Please select...
Yes
No
Lender Name
Upload your most recent tax returns, a copy or screen shot of your savings and two months of current paystubs for everyone who will be on your mortgage.
Requested Files
Type of file
File
Contact Information