Housing Intake Forms

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In-person intake is not available during the Coronavirus Pandemic. To accommodate Unemployment Information Center clients during this time we are offering online intake forms. If requested, please fill out the forms listed below to the best of your ability.

Click the link below to download and open the Housing Intake Form.

You will need to have Adobe Acrobat Reader, which you can download here for free Acrobat Reader

  • Install the Acrobat Reader on your computer.
  • Click on the Housing Intake form

Please fill it out to the best of your ability, and sign each page that requires an authorization or disclosure.

  • To create a signature, click on the icon of the fountain pen at the top of the form (not the left), add your signature, then drag your signature to each space where it is required.
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  • When you are finished, save the form. From the FILE tab at the top left, click on SAVE AS, with a name and location on your computer where you will be able to find it and email it to your housing counselor as an attachment.

1. Housing Intake form

Bertha Sarmina         bsarmina@philaup.org

Rian Franks                rfranks@philaup.org

Thurston Hyman       thyman@philaup.org

( If you do not know who your housing counselor is, please send the email to admin@philaup.org )

2. Prepurchase Intake Form

Rian Franks rfranks@philaup.org

You can also try emailing directly from inside the form, without saving to your device.

  • When you are finished filling and signing the form, click on the icon of the envelope at the top of the form.
  • Click on Invite People.
  • Add your counselor’s email address.

If you don’t know who your counselor is, type in admin@philaup.org

  • Click Send.
  • We will receive an email with the link to your filled-in form.