Eligibility Screening

ELIGIBILITY SCREENING QUESTIONNAIRE

This is a short pre-application to see if you may be eligible for our limited-term rental assistance program. This program is for households experiencing a housing crisis in Perth Amboy or Woodbridge.

This short questionnaire is the first step to see if our program is the right fit for your needs. Your honest answers will help us quickly determine if you should proceed to the full application.

Important: If you select No for Question 1, or certain options in Question 2, you will not be eligible to proceed. Household size and income will be screened against under 50% AMI for Middlesex County during review.

1. Are you 18 years old or older? (You have to be 18 or older to qualify.)

Yes No

2. Which of these applies to you? (You must be a current resident of Perth Amboy/Woodbridge, or if currently homeless, your last permanent address must have been in Perth Amboy/Woodbridge within the last 2 years.)

I am a current resident of Perth Amboy or Woodbridge, New Jersey I am currently homeless, but I had a permanent address in Perth Amboy or Woodbridge within the last 2 years I have been homeless for more than 2 years and do not have an address I am neither homeless nor a resident of Perth Amboy or Woodbridge

3. How many people, including yourself, live in your household? (Income must be under 50% AMI to qualify.)

4. Please enter the TOTAL gross annual income for all household members from employment and other sources.

Please enter numbers only (commas are okay). Example: 42,000

By continuing, you confirm the information is true and complete to the best of your knowledge.