Affordable Accomodation

Affordable Application

I am applying for*

Pines Court*

Bach - $550
1 Bdrm - $765
2 Bdrm - $910
3 Bdrm - $990

Creekside*

1 Bdrm - $765
2 Bdrm - $927

I have attached a copy of my Notice of Assessment from my previous year's tax return.

I have indicated my monthly source of income is (ex. Pensions, AISH etc.)*

I have indicated the number of bedrooms I require (Bach, 1, 2, 3)*

I use the following for mobility aid*

Walker
Wheelchair
No

Applicant #1

Name*

Date of Birth*

Present Address*

Postal Code*

Applicant #1 Email*

Present Landlord*

Phone #*

Tenancy start date*

Previous Address*

Postal Code*

Previous Landlord*

Phone #*

Tenancy start date*

Occupation*

Employer*

Annual Income*

Character or Landlord Reference*

Phone #*

Emergency Contact*

Phone #*

Applicant #2

Name

Date of Birth

Present Address

Postal Code

Present Landlord

Phone #

Tenancy start date

Previous Address

Postal Code

Phone #

Previous Landlord

Tenancy start date

Occupation

Employer

Annual Income

Character or Landlord Reference

Phone #

Emergency Contact

Phone #

Has either applicant previously rented from Conwood Seniors Housing or Bridges Community Living?

Yes
No

I/we hereby certify that all statements made in this application are true and I/we hereby autorize Conwood Seniors Housing to conduct a personal investigation/credit check and to contact any persons identified in this Rental Application. The failure to obtain an accurate and satisfactory credit report may, in Conwood Seniors Housing's sole discretion, adversely affect my/our application. I understand and acknowledge that if the application information provided is incorrect, Conwood Seniors Housing may at its option elect to terminate my tenancy agreement upon thirty days’ notice.

In order for Conwood Seniors Housing to comply with the federal and/or provincial privacy legislation, I/we understand that all personal information collected from me/us may be collected, used and disclosed by Conwood Seniors Housing for the purpose of my/our application assessment, for the purpose for debt collection, to uphold and maintain the rules and regulations of the property, to evaluate my/our tenancy, to comply with applicable law and in the ordinary course of Conwood Seniors Housing’s business, including, but not limited to, any refinancing or potential sale of the property.

Applicant #1*

Phone #*

Date*

Applicant #2

Phone #

Date

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