Fillable APPLICATION FOR FSS PROGRAM The Family Self-Sufficiency Program (New Hampshire Housing)

Fill Online, Printable, Fillable, Blank APPLICATION FOR FSS PROGRAM The Family Self-Sufficiency Program (New Hampshire Housing) Form

Use Fill to complete blank online NEW HAMPSHIRE HOUSING pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

APPLICATION FOR FSS PROGRAM The Family Self-Sufficiency Program (New Hampshire Housing)

On average this form takes 12 minutes to complete

The APPLICATION FOR FSS PROGRAM The Family Self-Sufficiency Program (New Hampshire Housing) form is 3 pages long and contains:

  • 0 signatures
  • 51 check-boxes
  • 23 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your New Hampshire Housing forms online.

BROWSE NEW HAMPSHIRE HOUSING FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
1
4/18/2017
APPLICATION FOR FSS PROGRAM
The Family Self-Sufficiency Program is a five-year employment focused program. See the FSS
Information Sheet for more information. If you are interested in enrolling in FSS, the voucher
Head of Household must complete and return this application.
Name: Date of application:
Email address:
Best phone number: Best day/time to call:
Employment
1. Are you able and willing to work? Yes No Don’t know
If you are concerned about your ability to work due to a health issue or disability, please contact
your medical provider to discuss whether working is advisable. When you know that you are
able to work at least part-time then you may enroll in GOAL.
2. Are you currently employed? Full-time Part-time Not working
Employer’s Name:
Position:
When did you start working there?
Are you eligible for benefits through you’re the company even if you have to pay?
Health Insurance Retirement benefits Other:
3. How committed you are to working to improve your employment situation?
4. What challenges get in the way of your being employed or better employed?
Transportation
Health
Childcare
Alcohol or drug use
Need additional education
Other, please list:
2
4/18/2017
Education
1. How many years of school have you completed?
2. Do you have a High school diploma? Yes No
3. Do you have a GED or Hi-Set certificate? Yes No
4. Are you currently enrolled in a certificate training program? Yes No
If yes, where?
What is your course of study?
When do you plan to finish/graduate?
5. Are you currently enrolled in a job training program? Yes No
If yes, where?
What is your course of study?
When do you plan to finish/graduate?
6. Are you currently enrolled in college? Yes No
If yes, where?
What is your course of study?
When do you plan to finish/graduate?
Money Management
1. Do you have a checking and/or a savings account? Yes No
2. Do you have direct deposit of your paychecks or benefit checks? Yes No
3. Do you have a household budget? Yes No
4. Do you save regularly? Yes No
Online Access
1. Do you have access to a computer? Home Work Other:
2. Do you have access to the internet? Home Work Other:
3
Rev. 4/18
3. Do you have a smart phone? IPhone Android
4. Do you have a tablet? IPad Android
General – Check if anyone in your household receives the following?
TANF cash assistance
Medicaid and/or Healthy Kids
Food Stamps
Earned Income Tax Credit
Other General Assistance
Number of children under 12 in the household receiving childcare services?
English Language
1. How well do you speak English?
2. How well do you understand English?
3. How well do you read English?
4. Have you taken an English class? Yes No Currently taking
Please return this application in the enclosed envelope. Once your application has been
reviewed and approved you will receive a contract of participation to sign and return. We
will contact you to go over the contract and get you started on the FSS program.
Questions? Please contact (Name of RAM) at 603-310- (number).
Thank you for your interest in the FSS Program!
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

APPLICATION FOR FSS PROGRAM The Family Self-Sufficiency Program (New Hampshire Housing)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 30 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document