Please Choose the Type of Housing You Are Applying For:*

Public Housing Pre-Application

Note: One submission per household only

Section 8 Housing Choice Voucher Program Pre-Application

Note: One submission per household only

Affordable Rentals Pre-Application

Note: One submission per household only

Upscale Rentals Pre-Application

Note: One submission per household only

Homes to Own Pre-Application

Note: One submission per household only

Check all that apply*

Sylvania Homes
River Oak Apartments
Emma Lazarus Townhomes
726 North 11th Street
460 Centre Avenue
331 Elm Street
201 North 3rd Street

How many bedrooms are you seeking?*

Check all that apply

1 Bedroom
2 Bedrooms
3 Bedrooms
4 Bedrooms

Do you currently have a Section 8 Housing Choice Voucher?*

Yes
No

For applicants to 201 North 3rd Street, do you qualify for preference as an Artist?*

link for definition of eligibility on 201's page

Yes
No

Number of Persons in the Family (determines bedroom size)*

RHA occupancy standards are 2 persons per bedroom, with the following exceptions only: Parent and child do not have to share a bedroom. Grandparent and grandchild do not have to share a bedroom. Siblings of different genders, in which at least one is age 5 or over do not have to share a bedroom. In all other conditions, RHA awards one bedroom for every two persons.

Do you live, work, or attend school in the City of Reading?*

Yes
No

Is the Head of Household age 62 or older, or a person with a disability?*

Yes
No

Have you been displaced by city placard for reasons related to inhabitability of the owned or rental unit?*

Yes
No

Verification is required.

Are you a participant in Shelter Plus Care, seeking preference as a program graduate?*

Yes
No

Part 1: Head of Household

Name*

First Middle Last

Address*

Street Address Address Line 2 City

State*

Zipcode*

Social Security Number*

Date of Birth*

Sex*

Male
Female

Telephone Number*

Mobile Phone Number

Email*

If any household member has a disability and will require accommodation please define here:

Ethnicity*

Hispanic
Not Hispanic

Ethnic data for statistical purposes only.

Language

Proficiency:

I am able to speak, read, write, and understand in English
I have some difficulty with English. I am not always able to speak, read, write, or understand English

Preference:

I prefer to speak, read, and write in English
I prefer to speak, read, and write in Spanish

Race*

White
Black / African American
American Indian / Alaska Native
Asian
Native Hawaiian / Other Pacific Islander

Racial data for statistical purposes only.

Gross Income ($)*

Enter numbers only. Do not use commas or text.

How Often

If Income is from Wages, List Name and Address of Employer

Other Sources of Income

Part 2: Household Information

Address*

Street Address Address Line 2 City State ZIP Code

Is your mailing address different from the address above?

Yes

Mailing Address (if different from legal)*

Street Address Address Line 2 City State ZIP Code

Note: If your legal or mailing address changes, you must notify the Housing Authority in writing to maintain your waiting list status.

Do you require a Reasonable Accommodation for a disability to proceed with the application process?*

Yes
No

2nd Household Member

Name*

First Middle Last

Social Security Number*

Date of Birth*

Sex*

Male
Female

Disabled*

Yes
No

Relationship to Head of Household*

Ethnicity*

Hispanic
Non-hispanic

Race*

White
Black / African American
American Indian / Alaska Native
Asian
Native Hawaiian / Other Pacific Islander

Racial data for statistical purposes only.

3rd Household Member

Name*

First Middle Last

Social Security Number*

Date of Birth*

Sex*

Male
Female

Disabled*

Yes
No

Relationship to Head of Household*

Ethnicity*

Hispanic
Non-hispanic

Race*

White
Black / African American
American Indian / Alaska Native
Asian
Native Hawaiian / Other Pacific Islander

Racial data for statistical purposes only.

4th Household Member

Name*

First Middle Last

Social Security Number*

Date of Birth*

Sex*

Male
Female

Disabled*

Yes
No

Relationship to Head of Household*

Ethnicity*

Hispanic
Non-hispanic

Race*

White
Black / African American
American Indian / Alaska Native
Asian
Native Hawaiian / Other Pacific Islander

Racial data for statistical purposes only.

5th Household Member

Name*

First Middle Last

Social Security Number*

Date of Birth*

Sex*

Male
Female

Disabled*

Yes
No

Relationship to Head of Household*

Ethnicity*

Hispanic
Non-hispanic

Race*

White
Black / African American
American Indian / Alaska Native
Asian
Native Hawaiian / Other Pacific Islander

Racial data for statistical purposes only.

6th Household Member

Name*

First Middle Last

Social Security Number*

Date of Birth*

Sex*

Male
Female

Disabled*

Yes
No

Relationship to Head of Household*

Ethnicity*

Hispanic
Non-hispanic

Race*

White
Black / African American
American Indian / Alaska Native
Asian
Native Hawaiian / Other Pacific Islander

Racial data for statistical purposes only.

7th Household Member

Name*

First Middle Last

Social Security Number*

Date of Birth*

Sex*

Male
Female

Disabled*

Yes
No

Relationship to Head of Household*

Ethnicity*

Hispanic
Non-hispanic

Race*

White
Black / African American
American Indian / Alaska Native
Asian
Native Hawaiian / Other Pacific Islander

Racial data for statistical purposes only.

8th Household Member

Name*

First Middle Last

Social Security Number*

Date of Birth*

Sex*

Male
Female

Disabled*

Yes
No

Relationship to Head of Household*

Ethnicity*

Hispanic
Non-hispanic

Race*

White
Black / African American
American Indian / Alaska Native
Asian
Native Hawaiian / Other Pacific Islander

Racial data for statistical purposes only.

9th Household Member

Name*

First Middle Last

Social Security Number*

Date of Birth*

Sex*

Male
Female

Disabled*

Yes
No

Relationship to Head of Household*

Ethnicity*

Hispanic
Non-hispanic

Race*

White
Black / African American
American Indian / Alaska Native
Asian
Native Hawaiian / Other Pacific Islander

Racial data for statistical purposes only.

10th Household Member

Name*

First Middle Last

Social Security Number*

Date of Birth*

Sex*

Male
Female

Disabled*

Yes
No

Relationship to Head of Household*

Ethnicity*

Hispanic
Non-hispanic

Race*

White
Black / African American
American Indian / Alaska Native
Asian
Native Hawaiian / Other Pacific Islander

Racial data for statistical purposes only.

Part 4

Supplemental and Optional Contact Information

Yes
No

You have the right to include as part of your application contact information for a person or organization that may be able to help you resolve any issues that may arise during your tenancy or to assist in providing any special care or services you may require should you become a tenant. You are not required to provide this contact information, but if you choose to do so, please click the "Yes" option and complete the field below.

Enter Supplemental and Optional Contact

Certification*

I agree

I certify that the information provided is true and complete to the best of my knowledge and belief. I understand that I can be fined up to $10,000 or imprisoned up to five years if I furnish false or incomplete information.

Public Housing

Housing Choice Voucher Program

Affordable Rentals

Upscale Rentals

Homes to Own

Resident Services

Monthly Rent

Maintenance

Safety

Pre-Application

Public Housing Pre-Application

Section 8 Housing Choice Voucher Program Pre-Application

Affordable Rentals Pre-Application

Upscale Rentals Pre-Application

Homes to Own Pre-Application

Part 1: Head of Household

Part 2: Household Information

2nd Household Member

3rd Household Member

4th Household Member

5th Household Member

6th Household Member

7th Household Member

8th Household Member

9th Household Member

10th Household Member

Part 4

Public Housing

Housing Choice Voucher Program

Affordable Rentals

Upscale Rentals

Homes to Own

Resident Services

Monthly Rent

Maintenance

Safety