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Prequalification Application:

Please answer all questions to the best of your ability. Items with an asterisk (*) must be answered.

** Read carefully, some questions may or may not require an answer based on your responses to certain conditions. Such as whether or not you have a Co-Applicant.
If you do have a Co-Applicant, then those fields need to be filled in even though they do not have an asterisk (*).

NOTE: If you miss answering a required field then the system will report the field when you click [NEXT] and allow you to fill in your answer before proceeding.

Don't worry if you don't have all of the answers, just answer to the best of your knowledge. We'll contact you if we need more information.

- Please proceed -

1. Email address*


2. Title

3. First Name:


4. Middle Name

Middle Name or Initial

5. Last Name


6. SSN:

Social Security Number:

7. DOB

Please enter your Date of Birth.

8. Schooling:

Please enter total Years of School.

9. Marital Status*

Are you single, married or separated?

10. Dependants

Please enter your number of Dependants.

11. Dependants Ages:

Please enter your Dependants ages, separated by commas.

12. Mailing address:


13. City


14. State


15. Zip Code


16. Phone#:


17. Best time to call?

Please indicate the best time to call you. Morning, afternoon or evening. You can be specific if you like.

18. Cell Phone#


19. Fax#


20. Other Contact Info:

Is there any other contact information you feel we might need? Work phone, relatives, neighbors or friends phone, etc.

Romans 8:31

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Copyright © 2008-2014, Bolton Mfd. Homes, Inc., All rights reserved 
8119 Hwy 28 W., Alexandria, LA 71303
1-800-677-9479 
customerservice@boltonhomes.net