I swear, to the best of my ability and knowledge, that the information provided herein is truthful and accurate.
I understand that the information provided in this pre-application will be used to assess my family's potential eligibility for the Pittsburgh Scholar House Housing Program. I understand that a determination of potentially eligible does not constitute a definitive eligibility determination, and that all information contained herein must be verified by Pittsburgh Scholar House and/or the Housing Authority of the City of Pittsburgh before an official eligibility determination can be made.
I agree to submit all documentation requested as part of an official eligibility determination within 10 business days of the date it is requested of me.
I understand that completion of this application, a potential eligibility determination, and/or a final eligibility determination does not guarantee that my family will be placed into Pittsburgh Scholar House Housing Program housing. I understand further that I may be determined ineligible for the program. Additionally, I understand that I may be placed on a waitlist for housing.
I agree to maintain confidentiality and refrain from publicly identifying families, staff members, and others who I come in contact with during the course of my involvement with the Pittsburgh Scholar House Housing Program.
By signing this form, I further consent to and authorize Pittsburgh Scholar House to disclose in good faith my participation in the program to third parties, including my college or university, employers, government entities and/or other entities for the purpose of obtaining verification of college enrollment, household income, public assistance payments and/or other information required to certify my household's eligibility for the Pittsburgh Scholar House Housing Program and/or the Housing Voucher Program.
Lastly, I understand and agree to submit a detailed criminal background check.
With my signature, I attest that I have read and understand the stipulations and requirements laid out above.