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If you’re a healthcare worker who dreams of owning a home but faces financial barriers, we’d love to hear your story. A grant from Homes for Healthcare Workers could help make that dream a reality.

Section 1: Applicant Information

Full Name * Age Range * Preferred Method of Contact * Phone Number * Email Address * Number of Dependents * Military Status *

Section 2: Healthcare Employment Information

Current Healthcare Role * e.g. Nurse, CNA, Medical Assistant, Caregiver, Therapist, Home Health Aide, Hospital Support Staff Current Employer * How Long Have You Been Employed With Your Current Employer? * Briefly Describe Your Healthcare Role * Tell us about the work you do and how you help patients, families, or your community.

Section 3: Homeownership Goals

Have You Owned a Home Within the Last 3 Years? * What State Are You Hoping to Purchase a Home In? * When Are You Hoping to Purchase a Home? * Estimated Annual Household Gross Income * Include income from all household sources. Credit Score Range * Are You Currently Working With a Loan Officer? * Are You Currently Working With a Real Estate Agent? *

Section 4: Your Story

Tell Us About Yourself * Please tell us about your healthcare career, why you chose to work in healthcare, what homeownership would mean to you and your family, what barriers are making it difficult to purchase a home, and how a Homes for Healthcare Workers grant would help you achieve your goals. 500–1,500 words recommended.

Grant Program Acknowledgement

I understand that grant awards are not guaranteed and are subject to review and approval. I understand that certain directors, officers, employees, affiliates, sponsors, referral partners, or associated professionals of Homes for Healthcare Workers may also work in real estate, lending, or related industries and may earn commissions or other compensation through those separate professional activities. I understand that grant eligibility and grant awards are not dependent upon the use of any particular real estate agent, lender, vendor, or service provider. I certify that the information provided in this application is accurate to the best of my knowledge. I understand that if awarded a grant, I will have 30 days to identify a property and enter into a purchase contract. If I am unable to secure a property within 30 days, I may request a one-time 15-day extension or reapply during a future grant cycle. I authorize Homes for Healthcare Workers to contact me regarding my application.