Eligibility Questionnaire

Please answer the following questions and you will be contacted by a representative of CHDC. Thank You.

Name*

Title

First

Last

Phone*

Email*

Address*

Street Address City State / Province / Region Postal / Zip Code Country

Length of time at your current address*

Number of people in your household*

Length of time at your current employer*

Salary*

Household income*

How are you financing the purchase of your vehicle?*

Phone: (510) 685-4303