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The Community Development Block Grant (CDBG) funds CityLink's Evening Service to provide transportation for individuals to get to and from work or job training and school programs.
Number of Adults
Number of Children (18 years old or younger)
Income Falls within the established limits for participation in the CDBG program as indicated below:
By signing below I affirm that I have received information concerning the rules, regulations, and procedures related to use of the CityLink Special Services and agree to follow the established guidelines to the best of my ability.
I confirm that the information that I have provided to CityLink on this form is true and correct. I understand that this information is being used to determine my eligibility for participation in the Community Development Block Grant (CDBG) transportation program and that any information that I provide, including household income information, is subject to verification.
This field is not part of the form submission.
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