First Name
*
Last Name
*
Date of Birth
*
MM
DD
YYYY
Email Address
*
Current Address
*
Address where you currently reside
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
County of Residence
*
Phone
*
(###)
###
####
Emergency Contact Name
*
Emergency Contact Phone
*
Emergency Contact Relationship to Contact
*
Gender Identity (check one)
*
Race
*
Check all that apply
How many years or months (specify) have you been a resident of Austin/Travis County or surrounding counties?
*
How long have you (or had you) been a continually working musician?
*
Music Career Details
In several sentences, please tell us in more detail about your music career over the past 20+ years. The more information you can provide, the better. (Who you played with, CDs you are on, tours you have participated in, studio work done and with who, what brought you to Austin, etc.)
Job #1
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Job #2
*
Job #3
*
Address #1
*
Address #2
*
Address #3
*
Reference #1
*
Reference #2
*
Reference #3
*
What is your household's current monthly gross income?
*
What is your current monthly gross income?
*
Live music (gig) shows
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Recording work
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Royalties
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Music lessons
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Merchandise
*
Instrument repairs or manufacturing
*
Income from non music work (yoga, child care, office work, etc)
*
Social security
*
Veterans benefits
*
Pensions
*
Unemployment
*
Annuities
*
Investments
*
Inheritance
*
Other income or financial assistance (please describe)
Number of Dependents
*
When is the last year you filed with the IRS?
What is the current household size and make up of the home you live in? (This is the total number of people living in the household you reside in including yourself.)
*
Length of time at current residence
*
When does your current lease or living arrangement end?
What utilities are you responsible to pay monthly?
*
If you rent or own, what is your current mortgage or rent payment monthly?
What is the reason/s you have or would move?
Check all that apply
Requested Amount and Utility
*
What is the amount you are requesting, and how will you use it? Remember that HOME provides housing support and nothing else. This includes rent, deposits, and utilities mainly.
(Optional)
Date of Application Submission
*
MM
DD
YYYY
