Winnebago County Housing Authority (WCHA)

Online Waiting List Application

3617 Delaware St. . Rockford, IL 61102 . (815) 963-2133 .

Registration

1

Head of Household

First Name *

Middle

Last Name *

Address *

Apt/Suite

City *

State *

Zip Code *

Phone *

Alternate Phone

Social Security *

Email Address

Birthday *

Gender *

Do you have a disability? *

For HUD Statistical Purposes Only

Please identify your race and ethnicity in each of the two categories below.

Hispanic or Latino

Not Hispanic or Latino

Check All That Apply

2

Household Member Information

Please provide the following information about all household members, starting with those over the age of 18.

How many additional household members do you have (not including yourself)?

3

General Household Information

Household Income

Please provide your household's total gross annual income. This includes Supplemental Security Income (SSI), wages, Social Security, Temporary Assistance for Needy Families (TANF)/welfare for every household member.

Income

Indicate your desired application for each of the housing programs (Location) and (bedroom sizes offered).

Rental Housing Support Program - Jo Davies County (1 - 2 bedrooms) *

Yes

No

Rental Housing Support Program - Ogle County (1 - 3 bedrooms) *

Yes

No

Rental Housing Support Program - Village Green Apts in Mount Morris IL (1 bedroom - 62 or older only) *

Yes

No

Rental Housing Support Program - Valley View Apts in Rockford IL (Studio - 1 bedroom, Disabled or 62 older only) *

Yes

No

Rental Housing Support Program - Grand Apts in Rockford IL (Studio only) *

Yes

No

Rental Housing Support Program - Skyrise Apts in Rockford IL (Studio - 1 bdrm, 55 and older only) *

Yes

No

Freeport RAD 1 – Hosmer and Brewster Apartments – Freeport (1 Bedroom) *

Yes

No

Freeport RAD II - Westport Village Apts - Freeport (1 - 3 bdrms) *

Yes

No

Rental Housing Support Program- Winnebago County (2-3 bedrooms) *

Yes

No

General Questions

Current resident of Winnebago County within past 90 days: *

Yes

No

Current resident of Stephenson County within past 90 days: *

Yes

No

Current nursing home resident who has resided in a state-licensed nursing home for the past 90 days: *

Yes

No

Custody of the child welfare system on or before 18th birthday and not yet 24: *

Yes

No

VAWA-Are you are a victim of violence in reference to the Violence Against Women’s Reauthorization Act of 2013? *

Yes

No

Currently meet the HUD/Social Security definition of disabled: *

Yes

No

Currently working: *

Yes

No

Veteran or surviving spouse of Veteran: *

Yes

No

Head of household or spouse is 62 years old or older: *

Yes

No

4

Certification

By checking below, I certify that the above information is accurate and complete.

I understand that submission of false information or misrepresentation may result in loss of eligibility for the housing program associated with this waiting list application. By checking the "I agree" box below, I certify that the information is complete and accurate.

I agree

Current Time: 04/29/2025 11:04pm

Registration is currently open

The application must be filled out completely in order to have an opportunity to be placed on the waiting list.

Fields marked with a * indicate required information.