Register Form

PROPERTY ADDRESS is

MONTHLY RENT of $

OCCUPANCY DATE DESIRED is

Last Name *Please fill the required field.

First Name *Please fill the required field.

Middle Name

Birth Date *Please fill the required field.

Drivers License/BC ID *Please fill the required field.

Home Phone

Cell Phone *Please fill the required field.

Email *Please fill the required field.

SIN (optional)

Name *Please fill the required field.

Age *Please fill the required field.

Name

Age

Name

Age

Name

Age

Name

Age

Name

Age

Present Address *Please fill the required field.

City *Please fill the required field.

Province *Please fill the required field.

Postal Code *Please fill the required field.

Date In *Please fill the required field.

Date Out *Please fill the required field.

Landlord Name

Landlord Phone Number

Monthly Rent/Mortgage $

Reason for Leaving

Previous Address *Please fill the required field.

City *Please fill the required field.

Province *Please fill the required field.

Postal Code *Please fill the required field.

Date In *Please fill the required field.

Date Out *Please fill the required field.

Landlord Name

Landlord Phone Number

Monthly Rent/Mortgage $

Reason for Leaving

Previous Address *Please fill the required field.

City *Please fill the required field.

Province *Please fill the required field.

Postal Code *Please fill the required field.

Date In *Please fill the required field.

Date Out *Please fill the required field.

Landlord Name

Landlord Phone Number

Monthly Rent/Mortgage $

Reason for Leaving

Occupation *Please fill the required field.

Company *Please fill the required field.

Employment Date

Employer Address

Employer Phone Number

Name of Supervisor

Current Monthly Salary/Wage

Other Monthly Income (ie. Parental Support, Income Assistance, Savings)

I Don't Have A Vehicle

Vehicle Make

Model

Colour

License Plate #

Type of Pet

Breed

Colour/Marking

Age

Size

Reference Name 1

Phone Number

Relationship

Reference Name 2

Phone Number

Relationship

Emergency Contact Name

Phone Number

Relationship

Have you ever been late with a monthly rent payment?

Have you ever filed for bankruptcy

Are you under 19 years of age?

Does anyone in your household smoke?

Do you have a water-filled furniture (waterbed, aquarium)?

Do you currently have tenants' contents and personal liability insurance?

Have you ever received a "Notice to End Tenancy"? If yes, please describe reason below

Notice to End Tenancy Reasons

3 + 4 = ?

Register Form

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