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 = ?

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Haitian Creole	Persian

Arabic	Hebrew	Polish
Bulgarian	Hindi	Portuguese
Catalan	Hmong Daw	Romanian
Chinese Simplified	Hungarian	Russian
Chinese Traditional	Indonesian	Slovak
Czech	Italian	Slovenian
Danish	Japanese	Spanish
Dutch	Klingon	Swedish
English	Korean	Thai
Estonian	Latvian	Turkish
Finnish	Lithuanian	Ukrainian
French	Malay	Urdu
German	Maltese	Vietnamese
Greek	Norwegian	Welsh
Haitian Creole	Persian

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