Pathways Application Form
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  • English (US)
  • Español

  • Para llenar la solicitud en español, haz clic arriba a la derecha donde dice “English” y cámbialo a “Español.”

  • Pathways Application Form

    This is an application to participate in Pathways, a program which connects households to an OUR Center Resource Specialist and/or to be considered for rental assistance.

  • ***If you need support completing the application, we offer assistance during Resource Now***

  • Date*
     / /
  • I am:*
  • Format: 000-000-0000.
  • What is their date of birth?*
     / /
  • If accepted, will you continue working with the family?*
  • What support are you requesting from the OUR Center?*
  • Date of Birth*
     / /
  • Format: 000-000-0000.
  • I am requesting help with....*
  • I have lived in the St Vrain Valley School District for at least 60 days.*
  • My name is listed on a legal lease agreement.*
  • Does your rent portion go up or down if your income changes? (ex: Section 8 voucher or project-based housing)*
  • Where is your voucher from?*
  • Do you have income?*
  • Within the last 30 days, have you had any source of income? (work, TANF, SSDI/SSI, child support, unemployment, etc.)*
  • Is the total household income enough to cover your monthly rent?*
  • Is the total amount you are requesting from the OUR Center more than $3,000?*
  • In the past 12 months have you received rental assistance from the OUR Center?*
  • 0/250
  • Gender:*
  • Marital Status*
  • Ethnicity*
  • Race:*
  • Have you ever served in the US Armed Forces?*
  • Do you have health insurance?*
  • Are you disabled?*

  • Please mark 'yes' or 'no':

  • Are you or is another adult in your household employed full-time?*
  • Do you have stable housing?*
  • Are you generally able to get to where you need to go using a personal vehicle or public transportation?*
  • Are you able to access enough food to feed yourself and your family?*
  • Have you finished high school or obtained your GED?*
  • Does everyone is your family have health insurance?*
  • If you are caring for a child: Do you have quality child care if needed?*
  • If you are caring for a child: Are all of your school-aged children enrolled in the current school year?*
  • Please select the option that applies to you*

  • Please add income for ALL household members below.

  • Please select all that apply and list the total amount below.*

  • I may revoke this authorization at any time, except to the extent that a Partner Agency has acted in reliance upon it, by sending written notification to any Partner Agency. I may acquire a copy of this release at my request. Expiration of Authorization: Unless terminated earlier by me, this authorization will expire one (1) year from the date signed.

     

    Puedo revocar esta autorización en cualquier momento, excepto en la medida en que una agencia asociada haya actuado basándose en ella, enviando una notificación por escrito a cualquier agencia asociada. Puedo obtener una copia de esta autorización si lo solicito. Caducidad de la autorización: A menos que la rescinda antes, esta autorización caducará un (1) año después de la fecha de su firma.

  • Please select submit.

  • Should be Empty: