Rebuilding Together NYC Workforce Training Program Application
Completion of this application document is the first step in starting the approval process for participation in the Disaster Recovery-Workforce Training Program. The attached application needs to be filled out completely. Please carefully read the instructions to complete the application and submit all required supplemental documentation, as required. Where requested, please be sure to provide information on each person living in your home.

Please note, the submission of an application is not a guarantee of Program participation. If you have any questions, please contact the Office of the Program Administrator at 718-488-8840.

We strongly encourage you to call and set-up an appointment if application assistance is needed. If any supplemental information requested by program staff is requested to be faxed or mailed, we also request for you to call and verify that your information has been received.

Itemized Instructions:

1. APPLICANT INFORMATION: Provide your legal name, an address where you are currently residing, receive your mail (may or may not be the subject property), an e-mail address (if applicable), your date of birth, and other fields.

2. RACE AND ETHNICITY: This information is being collected to ensure compliance with federal Housing and Equal Opportunity regulations.

3. EMPLOYMENT STATUS: Provide information on your current employment status.

4. INCOME INFORMATION: Provide information on all household income sources. Income includes the following: Wages, salaries and tips, alimony, child support, military income, part-time income, temporary income, Temporary Assistance for Needy Families (TANF), Social Security, other benefits, and other income for all household members over age 18.

5. SUPPORTIVE DOCUMENTS: Lists all supplemental documentation needed for application submission

6. APPLICANT CERTIFICATION: Certify that all information in the application is true, to the best of your knowledge. Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony for knowingly and willingly making false or fraudulent statements to any department of the United States Government.

7. ELIGIBILITY RELEASE: It is required that you sign this form, which allows GOSR and/or the Program Administrator to request information from Third Parties concerning your eligibility and participation in this program. This form allows for income, assets, child support, etc. to be verified and documented.

8. APPLICANT CERTIFICATION/VERIFICATION FORM: It is required that you sign this form authorizing final submission. This form will be used by Program personnel to verify submission and if eligible, application approval

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