Housing Application

  1. Housing Application
  2. Citizenship Attestation
  3. Background Check Agreement

I grant permission to share my name, contact information, and other relevant information on this form with other partnering agencies to assist in providing me with services. I understand that if I do not mark this box, I will be responsible for reaching out to Blair Tech Campus directly for further assistance on my own time.

  1. Any young adult ages 18-26 who is willing to participate in either employment advancement and/or education training.
  2. BTC requires a young adult is employed a minimum of 35 hours a week, enrolled in a minimum of 12 credit hours, or a combination of employment and education that equals 35 hours of productivity each week.
  3. Young adults agree to abide by Housing Rules:
    1. Resident agrees not to bring in or use:
      1. any drugs, drug paraphernalia, and, in the case of a minor, alcoholic beverages, alcohol containers
      2. weapons of any kind, type, or use. Actual weapons are not allowed on Blair Tech Campus property unless required by work or to eat/cook. This includes, but not limited to guns, BB guns/supplies, paint ball guns/supplies, large knives, or martial arts supplies.
      3. Any item that produces open flame (like candles and incense) or heat (like space heaters and fireplaces).
    2. There is no tobacco use, including vaping, in the apartments at any time. Residents may only smoke in areas outside the building.
    3. The premises shall only be occupied by those who have signed the housing contract. Occupancy by any other person is not permitted, except upon written consent of the BTC. (Overnight guests are limited to 2 consecutive nights, no more than 20 nights per calendar year – please notify BTC of any extended visit of anyone in your unit). Visiting children are exempt from the 20-night policy.
    4. Resident agrees to conduct themselves in a manner which will not disturb neighbor’s peaceful enjoyment of the building. Televisions, radios, stereos, any and all sound equipment and musical instruments should be played at levels as not to be heard outside of your unit, so as not to disturb the other residents (loud and excessive noises and disturbances that upset or disturb the other residents will not be tolerated). From Sunday to Friday, any noise reported by your neighbors after 10:00 PM will not be tolerated. The resident is responsible for paying any assessment or ticket issued by law enforcement. Upon the 3rd violation, you are subject to eviction. Please respect your neighbors right to peace.
    5. Resident agrees that any threatening behavior, verbal or physical, towards any resident, visitor, or staff member may result in immediate discharge from the facility.
    6. Resident agrees to keep their apartment clean and in good repair. Resident will work with other residents and staff to keep common areas clean.
    7. Resident understands that they will be held responsible for any damage done to the assigned apartment. Resident recognizes that no changes or alterations are to be made in the unit including, but not limited to painting, wallpapering, appliances, locks, windows, cabinetry, floor, utilities, or electrical.
    8. Resident understands that Blair Tech Housing is a secure building and agrees not to prop doors open for any reason or allow their assigned access card to be in anyone else’s possession at any time.
    9. All trash must be placed in trash bags and placed in the dumpster. Bags of garbage are not to be set in hallways, on stairways, landings, or any other part of the premises, not designed and intended to receive and hold garbage.
    10. There are no pets or animals allowed on BTC properties unless certified for a resident’s documented disability and approved by facility manager.
    11. It is recommended that the Resident have rental insurance.
    12. No signs, notices or advertisements shall be attached to or displayed by the Resident on or about the premises except with written permission from the BTC.
    13. NO day care facility can be operated on the premises by a resident.
    14. NO illegal activity is permitted in or around the premises. Violation of this Rule is grounds for immediate discharge from the facility.
    15. PARKING LOT– No one but residents and immediate guests may use the parking lot. PARKING IS ALOWED IN THE DESIGNATED AREAS ONLY! DO NOT PARK ON THE GRASS! There will be no dead storage of vehicles on the parking lot. Boats, motor homes, campers, trailers, etc. are not to be left for more than a weekend. Any repair and maintenance of vehicles (except changing a tire) is to be done elsewhere. A vehicle should not set more than 24 hours with a flat tire. The only exceptions are for guests per the 2-night maximum stay.
    16. Do not leave cigarette butts, cans, or bottles, etc. on the parking lot.
    17. No business may be run that involves lots of foot traffic and guests. Unless approved by BTC management.

I, the undersigned, understand that the above information is being considered for my acceptance into the Blair Tech Campus Housing Program. I also understand that this is only one part of the application process. Final acceptance into the program is based on application review and interview.

For the purpose of complying with Neb. Rev. Stat. 4-108 through 4-114, I attest the follows:

I am a citizen of the United States.


I am a qualified alien under the federal Immigration and Nationality Act, my immigration status and alien number are as follows: and I agree to provide a copy of my USCIS documentation upon request.

I hereby attest that my response and information provided on this form and any related application for public benefits are true, complete, and accurate and I understand that this information may be used to verify my lawful presence in the United States

Background check waiver agreement

I understand that I am authoring the BTC Intake Committee to review the results of my criminal history results as part of the intake process to enter Blair Tech Campus housing.

I understand that I am authoring the BTC Intake Committee to review to conduct a Child Protective Services background as part of the intake process to enter Blair Tech Campus housing.

I understand that the BTC Intake Committee will use the results of the background checks exclusively for authorized purposes. The BTC Intake Committee will not retain or release the results of the background checks outside of the Committee.

By signing this waiver, it is my intent to authorize the release and dissemination of my background check results to the BTC Intake Committee.