Drumlin Co-op Online App

Drumlin Co-op Online App
All persons who are 18 years of age or older MUST apply for membership. Any person over the age of 16 may apply for membership. Please answer all questions with detailed information on all applicants. If there are more than two (2) applicants, please contact our office via email at drumlin.co-op@sympatico.ca to have an application form sent to you for completion.

PLEASE NOTE THAT ALL PERSONS 18 YEARS OF AGE OR OLDER MUST SIGN THE DECLARATION FOLLOWING THEIR FINANCIAL INFORMATION. FOR MORE THAN TWO (2) APPLICANTS, PLEASE CONTACT OUR OFFICE TO HAVE A PAPER FORM SENT TO YOU.
1. APPLICANTS
APPLICANT # 1
APPLICANT #1

First NameLast Name
Date of Birth

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail Address
Are you a legal resident of Canada?

YesNo
APPLICANT # 2
APPLICANT #2

First NameLast Name
Date of Birth

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail Address
Are you a legal resident of Canada?

YesNo
2. Size of Unit Requested
Please indicate your preference(s)
3. Requested Move-In Date
Please indicate your desired Move-In Date

MonthDayYear
Number of days notice required at current residence
4. Please list all other members of the household below:
1. Name

First NameLast Name
Date of Birth

MonthDayYear
Gender
2. Name

First NameLast Name
Date of Birth

MonthDayYear
Gender
3. Name

First NameLast Name
Date of Birth

MonthDayYear
Gender
4. Name

First NameLast Name
Date of Birth

MonthDayYear
Gender

5. VOLUNTEER EXPERIENCE

The business and social affairs of Drumlin Co-operative are managed by the members with the help of staff. For this reason, skills and experience in group activities are important resources for the Co-operative. Examples of these are: activities in a trade union, tenants' associations, service clubs, election campaigns, civic committees, etc.
Please list any volunteer participation or other activities that might prepare you to contribute to the Co-operative:
6. Why do you want to live at Drumlin Co-operative?
Please provide your reasons for choosing our co-op?

7. VEHICLES

Parking is strictly enforced as per Municipal By-Laws and Drumlin's Vehicle Control Policy. Please list all vehicles (automobiles, trucks, vans, motorcycles, trailers, etc.) owned by the members of the family. Please be aware that you will require OFF-SITE parking for over-sized vehicles. We have limited parking for visitors and extra vehicles (more than two per houshold) and ask that you exercise courtesy at all times.
Vehicle # 1 Make, Model and Colour
Vehicle # 1 Plate Number
Vehicle # 2 Make, Model and Colour
Vehicle # 2 Plate Number
Applicant # 1 Drivers License Number
Applicant # 2 Drivers License Number
Insurance Company and Policy Number
Insurance Company and Policy Number
8. PETS

Please list all household pets below. Pets and their control are subjects of policy statements adopted by Drumlin Co-operative from time to time. You will be required to sign a "Pet Agreement". Please ask the Co-operative for a copy if you own or intend to own household pets. MAXIMUMS = Two small breed dogs (less than 50lbs) OR two indoor cats OR one large breed dog (over 50lbs) OR one smaller dog and one cat.
Please list your pets here

APPLICANT FINANCIAL INFORMATION - APPLICANT # 1

INCOME VERIFICATION WILL BE REQUIRED
APPLICANT # 1

First NameLast Name
Social Insurance Number
Do you require housing charge subsidy (rent geared to income)?

YesNo
Occupation
Employer Name
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Employer Phone Number

Area CodePhone Number
Years With Firm
Gross Monthly Income $ (before tax deductions)
Net Monthly Income $ (after tax deductions)
Applicant # 1 HOUSING INFORMATION
PRESENT LANDLORD NAME
Present Landlord Phone Number

Area CodePhone Number
Length of Occupancy
Present Rent $
Total Utilities Cost $
Applicant #1 Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Previous Landlord Name
Previous Landlord Phone Number

Area CodePhone Number
Length of Occupancy
Previous Rent $
Previous Total Utilities Cost $
Is there any reason why your landlord or previous landlord should not be contacted?
Have you lived in Ontario Social Housing (subsidized housing) before?

YesNo
Are you aware of any rental arrears that you are still owing to any landlord or housing provider?

YesNo
DECLARATION - I, the undersigned, do hereby apply for residence and membership in Drumlin Co-operative Homes Inc. I understand that a one-time $15.00 per adult membership fee is payable if the applicant is accepted for membership by the Board of Directors, and the payment of such a fee will thereby guarantee full rights of membership in Drumlin Co-operative Homes Inc. I declare that the information given on this application form is correct. I give the Co-operative permission to verify any or all of this information to establish credit worthiness and to do a landlord check and credit check. ***Please indicate your agreement by typing I AGREE in the box below, and provide your signature in the box following.*
Signature*
Date

MonthDayYear

APPLICANT FINANCIAL INFORMATION - APPLICANT # 2

INCOME VERIFICATION WILL BE REQUIRED
Applicant # 2

First NameLast Name
Social Insurance Number
Do you require housing charge subsidy (rent geared to income)?

YesNo
Occupation
Employer Name
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Employer Phone Number

Area CodePhone Number
Years With Firm
Gross Monthly Income $ (before tax deductions)
Net Monthly Income $ (after tax deductions)
Applicant # 2 HOUSING INFORMATION
PRESENT LANDLORD NAME
Present Landlord Phone Number

Area CodePhone Number
Length of Occupancy
Present Rent $
Total Utilities Cost $
Applicant # 2 Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Previous Landlord Name
Previous Landlord Phone Number

Area CodePhone Number
Length of Occupancy
Previous Rent $
Previous Total Utilities Cost $
Is there any reason why your landlord or previous landlord should not be called?
Have you lived in Ontario Social Housing (subsidized housing) before?

YesNo
Are you aware of any rental arrears that you are still owing to any landlord or housing provider?

YesNo
DECLARATION - I, the undersigned, do hereby apply for residence and membership in Drumlin Co-operative Homes Inc. I understand that a one-time $15.00 per adult membership fee is payable if the applicant is accepted for membership by the Board of Directors, and the payment of such a fee will thereby guarantee full rights of membership in Drumlin Co-operative Homes Inc. I declare that the information given on this application form is correct. I give the Co-operative permission to verify any or all of this information to establish credit worthiness and to do a landlord check and credit check. ***Please indicate your agreement by typing I AGREE in the box below, and provide your signature in the box following.
Signature
Date

MonthDayYear

DRUMLIN CO-OPERATIVE HOMES INC.

PERSONAL INFORMATION PROTECTION STATEMENT

I agree that Drumlin Co-operative Homes Incorporated may keep the following information about me: Contact Information; Emergency Contact; Medical Information; Employment Information; Household Size and Composition; Age, Gender, Family and Marital Status; Identification #'s (ie Social Insurance Number); Household Income; Banking and Credit Rating Information; Any payment records; Any incidents of property damage; Complaints/Grievances filed by others concerning the household; Previous housing situation.

I agree that this personal information may be made available to people in the following positions: Office staff; Auditors; Lawyer; Legal Authorities (ie police); Board of Directors; Government departments or agencies; Social Services; Membership Committee (**no financial, banking, credit, ID#, employment, medical info will be given to the membership committee. Only information relevant to conducting interviews will be given).

I understand that Drumlin Co-operative Homes Inc. will use the information to: Contact me about this application; Determine my eligibility for housing and membership in the Co-operative; Decide if I qualify for subsidy; Decide on any request for an internal move; Meet the requirements of federal or provincial laws, the Co-operative's by-laws or occupancy agreements or any legally binding contracts.

I understand that the Co-operative will retain my personal information only for as long as required and as required by law, contract, the Co-operative's by-laws and occupancy agreement. Personal information that is no longer needed will be destroyed.
APPLICANT #1 - I have read the PERSONAL INFORMATION PROTECTION statement and I am aware that I may request a copy of the Personal Information Protection statement at any time.

Yes
APPLICANT # 1 ***Please indicate your agreement to all terms set out in Drumlin's PERSONAL INFORMATION PROTECTION STATEMENT by typing "I AGREE" in the small box below and by entering your signature in the box following.
Signature-Applicant #1
Date

MonthDayYear
APPLICANT #2 - I have read the PERSONAL INFORMATION PROTECTION statement and I am aware that I may request a copy of the Personal Information Protection statement at any time.

Yes
APPLICANT # 2 ***Please indicate your agreement to all terms set out in Drumlin's PERSONAL INFORMATION PROTECTION STATEMENT by typing "I AGREE" in the small box below and by entering your signature in the box following.
Signature-Applicant #2
Date

MonthDayYear

Membership ApplicationAddendum
SCHEDULE “A”
(Each membership candidate must read and sign this addendum)

Information**
The word “Information” means credit information, personal information, information about the services you use that are provided by the Co-operative as listed in this application and information relating to your occupancy at the Premises applied for in this application including information regarding the duration of your occupancy, monthly housing charges, emergency contacts and any matters relating to your Occupancy Agreement, including misrepresentations relating to, defaults under and/or breaches of your Occupancy Agreement.

“Credit Information” means information about you, including your name, age, date of birth, occupation, place of residence, previous places of residence, occupancy length, marital status, co-occupant’s/spouse’s/same-sex partner’s name and age, number of dependants, particulars of education or professional qualifications, field of employment, places of employment, previous places of employment, employment durations, estimated income, paying habits, outstanding debt obligations, cost of living obligations, involvement in bankruptcy proceedings or landlord and tenant disputes, assets, and banking information (including account and credit card information).

“Personal Information” means information about you other than credit information that is relevant to your suitability as a member (occupant), including your social insurance number (optional), driver’s license number, vehicle license plate number, vehicle make and year, and information from references which you provide about your character, reputation, physical or personal characteristics or mode of living or about any other matter concerning you that is relevant to your suitability as a member (occupant).

Collection, Use and Disclosure of Information:
In consideration for the Co-operative accepting you as a member and entering into an Occupancy Agreement with you, you expressly consent to and authorize the following:

1. The Co-operative may obtain Information about you through a tenant check and/ or credit or consumer report conducted by Rent Check Credit Bureau and as permitted or required by law. You expressly authorize Rent Check Credit Bureau to provide Information regarding you to The Co-operative.

2. The Co-operative may use Information about you to determine your suitability as a member (occupant) and as permitted or required by law.

3. The Co-operative may disclose Information about you as permitted or required by law and to Rent Check Credit Bureau in order to be included within a database of tenant information, and/or within a file on you, for purposes of:

• tenant reporting and credit reporting in accordance with the Consumer Reporting Act (Ontario);

• establishing a credit history and a rental history;

• comparing with aggregate statistical data for purposes of tenancy and credit scoring; and

• supporting the credit approval process.

4. You expressly authorize Rent Check Credit Bureau to retain Information regarding you indefinitely for the purposes outlined in section 3 above, subject to any applicable legal restrictions.

5. You expressly authorize RentCheck Credit Bureau to disclose Information regarding you to its members and subscribers as required or permitted by law and for the purposes outlined in section 3 above.

6. You agree that you will not withdraw your authorization and consent to the collection, use and disclosure of Information about you by Rent Check Credit Bureau as outlined in sections 1 to 5 above.

7. You agree that all statements on this Membership Application are true and you expressly authorize all references given to release information about you to the Co-operative for verification subject to sections 1 to 5.

Please provide your consent by checking the following box and signing in the appropriate space below:
Applicant # 1

Yes, I have read and agree to the collection, use and disclosure of information as outlined above in the Membership Application Addendum.
Signature-Applicant #1: I have read, understood and voluntarily agree to the terms and conditions outlined in the Membership Application Addendum.
Date

MonthDayYear
Applicant # 2

Yes, I have read and agree to the collection, use and disclosure of information as outlined above in the Membership Application Addendum.
Signature-Applicant #2: I have read, understood and voluntarily agree to the terms and conditions outlined in the Membership Application Addendum.
Date

MonthDayYear
Should be Empty:

Rows	Have	Do Not Have
1. Farm Property which produces income
2. Real Estate which produces rental income (residential, commercial, farm, cottage, mobile home)
3. Savings Account (bank, trust company, credit union)
4. Annuities, Guaranteed Income Certificates, stocks or shares, bonds, debentures, mortgages, loans, notes, term deposits, mutual funds
5. License which produces income (ie Taxi License
6. Business interest which produces income
7. Life Insurance (with a cash surrender value)
8. Registered Retirement Savings Plan
9. Real Estate (house, condominium, summer cottages, farmland, commercial, or vacant land)
10. Life Insurance (with a cash surrender value
11. Collection of, or investments in, other valuable non-income producing assets
12. Business interest which does not produce income

Rows	Have	Do Not Have
1. Farm property which produces income
2. Real Estate which produces rental income (residential, commercial, farm, cottage, mobile home)
3. Savings Account (bank, trust company, credit union)
4. Annuities, Guaranteed Income Certificates, stocks or shares, bonds, debentures, mortgages, loans, notes, term deposits, mutual funds
5. License which produces income (ie Taxi License)
6. Business interest which produces income
7. Life Insurance (with a cash surrender value)
8. Registered Retirement Savings Plan
9. Real Estate (house, condominium, summer cottages, farmland, commercial, or vacant land)
10. Life Insurance (with a cash surrender value)
11. Collection of, or investments in, other valuable non-income producing assets
12. Business interest which does not produce income