Westmoreland County Expungement & Pardon Project Registration
For Low Income Households Of Westmoreland County with Pennsylvania Charges. You will be asked 13 questions to register for the event. This event is limited to 75 appointment spots. No Walk-ins.
Legal Name
*
First Name
Last Name
Maiden/Aliases/Other Names
Date of Birth
*
00/00/0000
Phone Number
*
Email
*
example@example.com
Zip Code
*
City
*
I am a Westmoreland County Resident
*
Yes
No
Requesting future assistance with: (Check all that apply)
*
Expungement
Pardon Application
Housing
Employment
Case Management Services
Food
Services for my children
Transportation Assistance
Substance use/ abuse services
Child Care/ Day Care
Other
Gender
*
Female
Male
Nonbinary
Choose not to self identify
Other
Race
*
Black or African American
White
Hispanic or Latino
Native Hawaiian or Pacific Islander
Asian
Native American or Alaska Native
Two or More Races
I Choose not to self identify Race
Other
Household Size. How many individuals reside in your household.
*
1 Just Me
2
3
4
5
6
Other
Estimated Yearly Household Income. Please select from the below.
*
No Income
Up to $10,000
Up to $20,000
Up to $30,000
Up to $40,000
Up to $50,000
Over $50,000
Other
Are you registered with or attended any of the following.
*
Westmoreland Community College (WCCC)
Drug Treatment Court
PA CareerLink
Private Industry Council
Westmoreland Casemanagement Services Inc (WCSI)
None / NA
The Westmoreland County Pardon Project Release Of Information. I understand the information collected above will be shared with the various partner organizations within the Westmoreland County Pardon Project for the purpose of providing additional services. I understand registering for the Pardon Project does not mean I am guarantee services and that additional information may be required. The information I have provided above is true and accurate to the best of my abilities.
*
Submit
Should be Empty: