First-time Homebuyer Intake Form

Introductory paragraph would go here. It’s not totally necessary, but we have one on the small business intake form page. It could also include a photograph.

" (Required)" indicates required fields

Homebuyer Intake

A non-refundable payment is required for homebuyer education course registration

Please review list of upcoming classes (opens in a new tab) to select class session

Class Session Registering for (Required)

Participant One

Name (Required)

First Middle Initial Last

Street Address (Required)

City (Required)

State (Required)

ZIP Code (Required)

Primary Email (Required)

Date of Birth (mm/dd/yyyy) (Required)

All correspondence will be sent to the primary email

Gender (Required)

Female

Male

Other/Non-Confirming

Veteran (Required)

Yes

Disabled (Required)

Yes

Head of Household (Required)

Yes

Were you born outside the United States? (Required)

Yes

Race (Required)

American Indian or Alaskan Native

Asian

Asian & White

Black/African American

Black/African American & White

Multi-Racial

Native Hawaiian/Other Pacific Islander

White

Ethnicity (Required)

Hispanic

Non-Hispanic

Education (Required)

Below H. S. diploma

H.S. diploma or G.E.D.

2 Yr College

Bachelor’s Degree

Graduate Degree

Saw your credit report in the last year?

Yes

Do you know your credit score?

Yes

Score

First Generation Homebuyer? (Required)

Yes

Add another participant

Participant Two

Name (Required)

First Middle Initial Last

Street Address (Required)

City (Required)

State (Required)

ZIP Code (Required)

Email (Required)

Date of Birth (mm/dd/yyyy) (Required)

Gender (Required)

Female

Male

Other/Non-Confirming

Veteran (Required)

Yes

Disabled (Required)

Yes

Head of Household (Required)

Yes

Were you born outside the United States? (Required)

Yes

Race (Required)

American Indian or Alaskan Native

Asian

Asian & White

Black/African American

Black/African American & White

Multi-Racial

Native Hawaiian/Other Pacific Islander

White

Ethnicity (Required)

Hispanic

Non-Hispanic

Education (Required)

Below H. S. diploma

H.S. diploma or G.E.D.

2 Yr College

Bachelor’s Degree

Graduate Degree

Saw your credit report in the last year?

Yes

Do you know your credit score?

Yes

Score

First Generation Homebuyer? (Required)

Yes

Household Information

Household Size

Number of adults (Required)

Number of children under 6 (Required)

Number of children between 6 & 18 (Required)

Household Type (Required)

Single Adult

Married without children

Married with children

Female-Headed Single Parent

Male-Headed Single Parent

Two or more unrelated adults

Annual Household Income (Required)

$0 - $9,999

$10,000 - $19,999

$20,000 - $29,999

$30,000 - $39,999

$40,000 - $49,999

$50,000 - $59,999

$60,000 - $69,999

$70,000 - $85,999

$86,000 - $100,999

$101,000 - $120,999

$121,000 - $150,999

>$151,000

Current Residence Type (Required)

What type of residence do you currently live in?

Single Family

Two Family Unit

Three Family Unit

Condo/Townhouse

Mobile Home

Four or more Family Unit

Home Purchase Plans

Residence Type (Required)

What type are you planning to buy?

Single Family

Two Family Unit

Three Family Unit

Condo/Townhouse

Mobile Home

Four or more Family Unit

Referral Source: (Required)

Lender

Realtor

State Agency

Media

Another Client

Walk-In

NeighborWorks America

Word of Mouth

Other

Please describe

Where are you in the home buying process? (please select all that apply)

Plan to purchase within 1 year

Plan to purchase within 2 years

Plan to purchase within 3-5 years

Actively looking to buy a house now

Are you working with a real-estate agent? (Required)

Yes

If so, with whom?

Are you approved with a lender? (Required)

Yes

If so, with whom?

Type of loan (Required)

MassHousing

One Mortgage

FHA

USDA

Other

If other, please describe

Have you made an offer or signed a P&S agreement? (Required)

Yes

Property Address (Required)

Do you have a closing date? (Required)

Yes

Closing date

Property Type (Required)

Single Family

Two Family Unit

Three Family Unit

Condo/Townhouse

Mobile Home

Four or more Family Unit

Is this a short sale property? (Required)

Yes

Is this a bank owned property? (Required)

Yes

Did you have a home inspection? (Required)

Yes

Loan Type (Required)

MassHousing

One Mortgage

FHA

USDA

Other

Please describe

Term (Years)

Interest Rate (%)

Purchase Price

Additional Information

Is it okay to use your comments or photo in print or on our website?

Yes

May we use your name?

Yes

Would you like to schedule an individual appointment with the Housing Counselor to review my/our credit report, budget, etc. and to further discuss my/our options?

Yes

Signature

THANK YOU FOR COMPLETING THIS FORM

I/We authorize NewVue Communities to:

I/We understand that a photocopy of this authorization is as valid as the original.
Text messaging will primarily be used for class participation confirmation and appointment reminders.
NewVue Communities provides pre-purchase group and individual education for potential buyers looking to buy their first home.
These services consist of a financial analysis, review of credit worthiness, budget consultation, mortgage readiness assessment,
resources on financial mortgage loan products and referrals. NewVue Communities also provides mortgage default services, housing
development services, small business services, community development services and asset management services. For a detailed list of
the services please visit our website at www.newvuecommunities.org.
I/We understand that NewVue Communities receives funds through the Housing Urban Development (HUD), NeighborWorks America
and Division of Banks (DOB) and as such, is required to share some of my/our personal information with program administrators or
their agents for purposes of program monitoring, compliance and evaluation.
I/We give permission for HUD, NeighborWorks America and DOB program administrators and/or their agents to follow-up with me/us
within the next three years for the purpose of program evaluation. This may include, but not limited to retrieving and reviewing client
credit information and records, including credit reports, and to conduct follow-up interviews/communications with clients for program
evaluation purposes.

Conflict of Interest / Disclosure

NewVue Communities does not receive any fee for service from any financial institutions to which we may refer you.
NewVue Communities does receive charitable contributions from some financial institutions. For a complete list of donors
please visit our website at www.newvuecommunities.org.
You are in no way obligated to receive any services offered by NewVue Communities or any of our partners. The staff and
board of NewVue Communities does not have any personal stake, financial or otherwise, in referring clients to any particular
product or service.

Acknowledgement

I have downloaded the HUD FHA Get a Home Inspection for Your Protection handout and 10 important questions to ask the home inspector
I/We also certify that I/we have downloaded the Privacy Policy and Practices of NewVue Communities.
Download the documents (PDF, opens in a new tab)

Participant One

Signature - second (Required)

I agree to the above.

Name (Required)

Date (Required)

MM slash DD slash YYYY

Participant Two

Signature - participant two (Required)

I agree to the above.

Name (Required)

Date (Required)

MM slash DD slash YYYY

This field is for validation purposes and should be left unchanged.

Our Programs

Help With a Home

Small Business

Community Organizing

First-time Homebuyer Intake Form

Homebuyer Intake

Participant One

Participant Two

Household Information

Home Purchase Plans

Additional Information

Signature