Housing Counseling and Education Disclosure Form Please enable JavaScript in your browser to complete this form.Organization Description and Agency Conduct: NeighborWorks Pocatello is a nonprofit, HUD-approved housing counseling agency. Our service offerings include both free and low cost educational workshops, as well as pre-purchase, non-delinquency post-purchase, financial fitness, default/foreclosure mitigation, and reverse mortgage counseling. NeighborWorks Pocatello is committed to serving all clients equitably, without regard to income, race, color, religion/creed, sex, national origin, age, family status, disability, or sexual orientation/gender identity. All programs and services are administered in conformity with local, state, and federal anti-discrimination laws. No employee, officer, director, contractor, or agent of our organization will engage in conduct that gives preference to any person, household, or organization, nor will they engage in any action that would create a real or apparent conflict of interest in the administration of housing counseling and/or educational services. Client Freedom of Choice, Agency Referrals, and Alternatives: Please be advised that, as a customer or client participating in any NeighborWorks Pocatello housing counseling and/or education service, you are not obligated under any circumstances to utilize or participate in any other service or program offered by our organization, as a condition of receiving housing counseling and/or educational services. When applicable, and/or upon your request, our organization may provide you with a list of alternatives and/or referrals for other programs, services, or products. Be advised that you are entitled to select whichever housing-related, or non-housing-related service or product that best meets your needs, regardless of any referral or alternative that may be provided to you by our organization during your participation in any education and/or counseling service. Agency Relationships: NeighborWorks Pocatello is a sub-recipient of federal funding from the U.S. Department of Housing and Urban Development (HUD), through a national intermediary, NeighborWorks America. NeighborWorks Pocatello also has financial or professional affiliations with the following financial institutions: Bank of Idaho, Citizens Community Bank, D.L. Evans Bank, Idaho Central Credit Union, Ireland Bank, J.P. Morgan Chase and Co., Key Bank, U.S. Bank, Washington Federal, Wells Fargo, Westmark Credit Union, and Zions Bank. As a customer or client participating in any NeighborWorks Pocatello educational and/or counseling service, you are not obligated to utilize the products or services of any of our exclusive financial and/or professional affiliates or partners as a condition of receiving housing counseling and/or educational services. Privacy NeighborWorks Pocatello is committed to protecting the private and personal information disclosed to us by our customers and clients. During the course of receiving housing counseling and/or educational services, we may collect information about you in a variety of ways including, but not limited to: application and intake data, information disclosed verbally during counseling sessions/interviews, information disclosed in writing (e.g. email), information provided to us by your creditors and/or lenders, etc. In order to meet compliance and auditing requirements, we are obligated to share information about our customers and clients with entities that provide funding for our education and counseling programs and services, including the U.S. Department of Housing and Urban Development and NeighborWorks America. We make every effort to safeguard the confidentiality of all personal and private information during its collection, processing, and dissemination, with due regard for all applicable ethical standards, and local, state, and federal regulations. I/We Acknowledge that I/we received, reviewed, and agree to NeighborWorks Pocatello’s program disclosure: PLEASE SIGN BELOW *Clear SignatureName *FirstLastDate SignatureClear SignatureNameFirstLastDate Submit