Senior Housing Application

Lions Ron Morrice Manor (55 + Only)

    1. Applicant(s) Information

    Please list all persons below who would be residing in this housing unit should this application be accepted. 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*


    Not Applicable


    2. Please provide all current phone numbers





    3. Provide your email address (one email only)


    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:


    Postal Code*:

    5. Do you have Pets?

    Do you have pets? YesNo

    **Pets are not accepted at Lions Manor

    6. Do you require wheel chair access?

    Wheelchair Accessible?* YesNo

    7. 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

    8. 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: $

    9. 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?* YesNo

    10. Parking

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

    Make / Model:

    License Plate No.:

    11. 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

    12. No Smoking policy

    By checking this box the applicant(s) acknowledge understanding that the Mt. Seymour Lions Manor resident units, building and surrounding grounds are strictly smoke and vape free; that any tenancy offered will include a material term covenant for each tenant and guest not to smoke, burn or otherwise combust material in the rental unit, outdoor balconies or on the entire property at any time or for any purpose.

    13. Anti-spam Quiz

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

    Please scroll up to top for submission status.

    An email will be sent to you on successful completion of the application.

    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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