Index
Elkhart: 574-264-1001 
Goshen: 574-971-8484 
Contact Information
Do you have a valid drivers license?
How long have you been at your current residence?
Yes  No  year(s)   month(s)        Do you  Rent  Own
Please type in your zip code. How long were you at your previous residence (if applicable)?
 year(s)   month(s)        Did you  Rent  Own
Please type in your monthly net income. How long have you been at your current place of employment?
 year(s)   month(s)
Do you have a co-signer? How long were you at your previous place of employment (if applicable)?
Yes  No  year(s)   month(s)