Private Housing Voucher Program Application

Private Housing Voucher Program Application

Apply for a 12-month housing subsidy. Please review eligibility criteria, prepare required documents, and submit the nonrefundable $45 application fee.
Eligibility Criteria & Instructions

Please read the following eligibility criteria before completing your application: - Must be a resident of the service area - Demonstrate housing need (e.g., risk of homelessness, unstable housing) - Provide proof of income and current employment or education status - Agree to participate in financial education, case management, and background checks - The subsidy term is 12 months with possible renewal based on compliance All fields are required unless stated otherwise. Prepare digital copies of your photo ID, income proof, and housing need documentation for upload. The $45 application fee is nonrefundable.
Applicant Full Name*

First NameLast Name
Email Address*
example@example.com
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Current Residential Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
How long have you lived at your current address?*
Residency Verification Document (e.g., utility bill, lease agreement)*

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Employment or Education Status*

Employed full-timeEmployed part-timeUnemployedStudent (full-time)Student (part-time)Other
Proof of Employment or Education (e.g., paystub, enrollment letter)*

Cancelof
Monthly Household Income (before taxes)*
Proof of Income (e.g., paystubs, benefit statements)*

Cancelof
Describe your current housing situation and reason for applying*
Housing Need Documentation (e.g., eviction notice, overcrowding, unsafe conditions)*

Cancelof
Photo ID (e.g., driver's license, state ID, passport)*

Cancelof
Do you have dependents living with you?*

YesNo
If yes, please list the names and ages of dependents
I consent to participate in required financial education workshops as part of the program.*

I agree
I consent to ongoing case management and compliance monitoring for the duration of the subsidy term.*

I agree
I authorize the program to conduct background checks as part of the eligibility review.*

I agree
By submitting this application, I understand the subsidy term is 12 months and may be renewed upon review of my compliance with program requirements.*

I acknowledge and accept
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Private Housing Voucher Program Application

Eligibility Criteria & Instructions