Family Housing Application

Lions Garey Ham Court

Lions Terrace

Lions Plaza

1. Applicant(s) Information

Please list all persons who would be residing in this housing unit should this application be accepted (scroll below). If a member of the household is expecting, please include the child with an estimated birth date. You will be required to provide Identification for all persons listed on this application prior to being accepted.

Full Name*

Date of Birth*

   Relationship to Applicant A*

A.

Not Applicable

B.

C.

D.

E.

F.

2. Please provide all current phone numbers

Tel*:

Tel:

Tel:

Tel:

3. Provide your email address (one email only)

Email*:

4. Current Address

Please provide your current address. If you do not have a permanent address, please provide an address that we can use to mail you any information or updates.

Address 1*:

Address 2:

City*:

Postal Code*:

5. Do you have Pets?

Please advise the type and number of pets in your family. We have strict pet regulations and a pet damage deposit is required.

Do you have pets?* Yes No 

Number of Pets:

Type of Pet(s): Dog Cat Bird Other 

6. Eligibility

Please describe your eligibility for rent geared to income housing. Provide the following information on income for all adult applicants. Paperwork verifying this information would be required should you be accepted for one of our units.

Applicant A:

Source of Income

Location of Employment

How long there

Gross Annual Income

Applicant B:

Source of Income

Location of Employment

How long there

Gross Annual Income

7. References

Please provide the following reference information.

Present Landlord*:

Phone Number*:

How long there?*:

No. of bedrooms*:

Rent paid*: $

Previous Landlord:

Phone Number:

How long there?:

No. of bedrooms:

Rent paid: $

8. Moving

Please provide the reason why you want to move from your present address?

Are you required to provide one month notice to your present landlord?* Yes No 

9. Parking

Please provide the following information on your families vehicles. Please note, parking is provided for one vehicle only.

Make / Model:

License Plate No.:

10. Declaration

I/We declare that the information supplied on this application is true and correct. I/We understand that this application does not constitute an agreement on the part of the MOUNT SEYMOUR LIONS HOUSING SOCIETY to provide me/us with rental accommodation and that this application might not be retained by the MOUNT SEYMOUR LIONS HOUSING SOCIETY once the application has been reviewed for a particular housing project.
Required Click for submission
For the purpose of assessing this application, I/We hereby consent to allow the MOUNT SEYMOUR LIONS HOUSING SOCIETY permission to obtain credit and/or personal reports on me/us from one or more agencies or individuals. I/We hereby authorize agencies or individuals to provide whatever such information they may have to the MOUNT SEYMOUR LIONS HOUSING SOCIETY relative to an assessment of this application.

I/We accept the above terms *required

11. Anti-spam Quiz

To confirm you are human and not a spam robot please complete this simple quiz:

Please note: The MSLHS will mail out updates or information to the address provided. It is important to keep your information current in order to stay in the applicant pool. Incomplete applications will not be considered. This application will remain part of a larger pool of applicants and will not receive a date priority.

Tel: 604-929-9499
Fax: 604-929-9404

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