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Ramsey County Section 3 Application for Residents

Ramsey County wishes to ensure that employment, training, contracting and other opportunities generated by the investment of federal funds are available to recipients of government housing assistance and other low-income residents in the project location. In order to increase the effectiveness of outreach, eligible applicants are encouraged to complete this application. Eligible residents will be referred to businesses and other organizations providing training and employment opportunities, unless you indicate otherwise. Only contact information, skills and union affiliation will be made available. Other information will remain confidential.

Basic Information

Name      

Address      

City       County       State       ZipCode      

Home Phone       Mobile Phone       Other Phone       Email Address      

Section 3 Resident Eligibility (You can qualify if you live in the twin cities metropolitan area, receive certain types of public assistance, and/or if your family/household income is less than the limits shown below.

How many people live in your household/family?      

What is your family’s /household’s gross annual income for all members over 18 for the next 12 months?      

Do you live in Public /Indian housing? Yes No

Does your family/household receive Public Assistance? Yes No

(Section 8, MFIP, DWP, WIC, heating assistance, free or reduced lunch program, etc.)

Which programs?      

Applicable Skills and Affiliations Check all of the skills/special training that you may have:

Accounting Demolitiion/Deconstruction Landscaping

Archictecture/Drafting Drywall Machine Operation

Bricklaying Electrical Marketing/Communications

Carpentry Engineering Painting

Carpet Installation Fence Installation Plumbing

Computer/Information Management Janatorial Word Processing

Other (Please describe)      

If you are affiliated with a union, please provide the union name and number.      

Do you participate in a local Youthbuild Program Yes No Which one?      

I,      , certify that my answers in this application form are true and accurate to the best of my knowledge. I also understand that false or misleading information, subsequent submissions or interview may result in penalties, including but not limited to decertification from the Section 3 Program and/or termination of employment.

Signature _______________________________________________ Date ___________________________

Fax to HRA/CED 651 266 8039 or Scan and Email to denise.beigbeder@co.ramsey.mn.us

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