Application for affordable housing

Rental Housing Application
1: Are You Eligible for Our Housing?

NOW Canada Society offers different types of affordable and safe rental housing. Please review the eligibility requirements below and check the housing that applies to you. This is the only housing we currently have available, therefore if you do not provide the type of housing you require, we will not process your application.
Tutt Street / NOW Place - 1,2 and 3 bedrooms. Women with or without children only. Drug and alcohol free properties, requiring 10 months abstinence. No male visitors overnight. Pets currently not accepted.1060 Cawston - Studios, 1,2 and 3 bedrooms. Single women, moms or dads with their children, families and senior couples. Smoke and drug free building. Pets considered.Microsuites - For women only. Smoke and drug free accommodation. Pets considered. No parking available.The Cottages - 2, 3 and 4 bedroom townhouses for women and children fleeing abuse. Smoke and drug free accommodation. Pets considered. AGENCY REFERRAL PROCESS ONLY.
2: Your Household Composition and Current Housing
Please describe why you are leaving your current accommodation*
Have you, or any of your household been active in substance abuse? If yes, please provide details including when this substance use ended*
Do you require parking?

YesNo
Does anyone in your household have mobility concerns?*

yesno
If yes, please explain
Full Name*

First NameLast Name
Are you a Canadian Citizen?*

YesNo
If no, explain your status in Canada:
List all other household members who will be living with you. Include all: 1) Full name, 2) Date of Birth, 3) Gender and 4) relationship to you (i.e. spouse, common law, son, daughter)
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Date of Birth*

MonthDayYear
Gender*
E-mail
Do you rent or are you the owner?*

RentOwn
What is your monthly housing payment?*
How many bedrooms are in your current home?
Are you in a lease?*

yesno
If yes, what date does your lease end?

MonthDayYear
Date
Do you have any pets?

yesno
If yes, indicate what pets you have.
3: Your Household Income

Rents at NOW Canada are based on income. Each adult (19+) in the household needs to declare their income.
Cash/Bank balance $ or N/A
Savings $ blanks or N/A
Stocks/Bonds/Term Deposit $ blanks or N/A
RRSPs/Annuities $ blanksor N/A
Any real estate holdings $ or N/A
#1 Household Member -previous year Revenue Canada Notice of Tax Assessment Line 150 $ amount
#1 Household Member -current gross monthly income (prior to taxes and deductions) $ amount
*Income Source (check all that apply)

EmploymentE.I.Income Assistance (I.A.)/ Persons with disability (PWD)PensionsOther
If you selected other, please specify
#2 Household Member -previous year Revenue Canada Notice of Tax Assessment Line 150 $ amount
#2 Household Member -current gross monthly income (prior to taxes and deductions) $ amount
*Income Source (check all that apply)

EmploymentE.I.Income Assistance (I.A.)/ Persons with disability (PWD)PensionsOther
If you selected other, please specify
4: Your References
1) Current Landlord:First Name* Last Name* Phone number Phone Number Dates of tenancy: From Date To Date
2) Previous Landlord:First Name* Last Name* Phone number Phone Number Dates of tenancy: From To Previous address
3) Personal Reference:First Name* Last Name* Phone number Phone Number
5: Your Authorizations, Declarations and Understandings
All units may transition to smoke free. Would all applicants be willing to sign a "No Smoking" addendum?*

yesno
NOW Canada Society In this application “NOW Canada Society” or the “Society” refers to and includes: a) NOW Canada Housing AUTHORIZE COLLECTION OF PERSONAL INFORMATION I/we authorized the Society to make any inquiries that are necessary to verify the information given in this application and I/we authorize any person, corporation, government department, government agency, or social agency to release to the Society any information pertinent to the assessment of my/our application, Pursuant to the Personal Information Protection Act.
PRIVACY POLICY The Society’s privacy policy is available on a separate form. Due to changes in technology and legal requirements, we may revise this policy from time to time. It is the applicant’s responsibility to request a current copy.
AUTHORIZE SHARING INFORMATION I/We authorize and consent to the Society exchanging (receiving and giving) information about me/us with credit agencies and my/our previous landlords with whom I/We have had dealings. I/We understand that such information will be a factor in the Society’s decision to provide me/us with rental accommodation. I/We authorize the Society to
share the information on this application with other Public Housing Bodies, as defined in the Residential Tenancy Act Regulations, in order to increase my/our opportunities for affordable and/or subsidized housing.
NOT RENTAL AGREEMENT I/We understand this application does not constitute an agreement on the part of the Society or BCHMC to provide me/us with rental accommodation.
ACTIVE APPLICATION I/We understand it is my/our responsibility to advise the Society of any changes to the information given in this application and that it is my/our responsibility to contact the Society every 6 months from the date of this application to maintain an active file. I/We understand the Society will de-activate this application 6 months after my/our last contact with the Society.
INCOME DOCUMENTATION I/WE understand that upon request of NOW Canada Society I/WE will be required to supply complete income documentation to the Society in order to confirm MY/OUR declaration above and MY/OUR eligibility for the rental housing. DO NOT INCLUDE ANY INCOME DOCUMENTS WITH THIS APPLICATION, If requested, the required documentation will include all sources of income, assets and the three (3) most current months of all bank statements.
By signing this form I/We declare that all the information given in this application is true, correct and complete AND I/We acknowledge that I/We have read, understood Section 5 above and agree to the authorizations and consents that I/We have granted in this application.
Signed X * Signed X
Date Date
Important Note: Incomplete applications and applications not signed by all adult applicants will not be activated.
Please submit this application form to NOW Canada Society, 2970 Tutt Street, Kelowna, B.C. V1Y 8Z5,
Email: info@nowcanada.ca Fax: 250 868 3876 or complete on-line.
Should be Empty:

Rental Housing Application

1: Are You Eligible for Our Housing?

2: Your Household Composition and Current Housing

3: Your Household Income

4: Your References

5: Your Authorizations, Declarations and Understandings