Housing Application Form


IMPORTANT INFORMATION FOR APPLICANTS:

  • It is your responsibility to update your contact information every three (3) months (even if it’s just to say you are still interested and there are no changes) or when any changes occur, such as family composition, contact numbers, address, etc. Failure to do will result in your application being removed from the active applicant listing to inactive and your application will not be considered for housing.
  • Incomplete applications will be returned to you. If you would like some help in completing the application or have questions, please call our office and speak to reception or one of our Indigenous Support Workers. They will help you make sure the application is complete and correct.
  • Applications with no means of contact (no valid email and no phone number) will be shredded. Please make sure your application includes a way to contact you.'
  • Be prepared to provide income documents, references, previous landlord information, and Government Issued Identification if you are called for housing. 

OFFICE USE ONLY

File #______________________________________Date_________________________________________

Applicant Information

Who will be on the lease agreement?

Last NameFirst NameTitle
  
  

 

Contact Information

   
 
  
   

 

Household Information

List yourself, then all other household members that you expect to be living with you. If there are more than 8 members in your household,  please contact the office.

Last NameFirst NameRelationshipBirth DateAgeSex
1. 
2.    
3.   
4.   
5.     
6.   
7.   
8.    

 

Do you or anyone in your household identify as being an Aboriginal person of Canada?

If Yes, please select the option that best describes your Aboriginal identity:

If Other, Please Specify:

What Community are you from?

Use this space to tell us about yourself:

Housing Requirements

Do you or anyone in your household smoke in your home?

Do you have any pets?

If yes, how many pets in total?

TypeHow ManyWilling to Give Up?Breeds / Description
Dogs 
Cats 
Other 

Tell us where you would like to live. There are more people applying for housing than vacant units. Therefore, the time to find housing can be very long. To increase the chances of being offered a place to live, you might want to select a number of buildings or areas. However, please note that if you refuse two (2) offers of housing, your application will be cancelled. For that reason, you must be sure that you are prepared to live in any of the buildings or areas you list.:

Tell us more about yourself:

NOTE: A maximum of two (2) offers of housing will be made. If two offers are refused, your file will be cancelled. Please make sure you are willing to live anywhere listed above.

Health and Mobility Information

Do you or any household members have any mobility issues, health conditions or disabilities that we should be aware of? If so, please complete the following questions so that we may assist you with matching you to housing that best suits your needs. If you do not have a health condition or disabilities please skip this section:

Do you or any members of your household have restrictions with stairs?

Do you or any members of your household have restrictions with stairs?

If a wheelchair is used, it is used inside your home?

Can everyone in your household safely use all rooms in your current housing?

Please describe any special requirements or features that you may need in your housing related to your mobility or health condition:

Residency History

Have you previously been a tenant with AHSPG?
 

Are you looking for subsidized housing?
- If yes, complete the rest of this form. If no, you may skip to the end and sign the form.

- If yes, you may skip to the end and sign the form.

**If you are looking for subsidized housing please complete the rest of this form. **

Have you or any members of your household ever lived in subsidized housing?

If yes, provide the following information for all previous subsidized housing:

Name on TenancyName & Address of DevelopmentReason For Leaving Dates of TenancyMoney Owing
 
   
 
  

Income and Asset Information

Is anyone in the household receiving income assistance from the Ministry of Housing and Social Development (Social Assistance)?

For all other income sources, list gross monthly income (before deductions) for everyone age 19 or older.

Name (surname first)Name & Address of DevelopmentReason For Leaving
 
  
  
 

For any adult (age 19 or older) with no income, please tell us why there is no income.

Note:  If any adult (age 19 or older) is a full-time student, proof of student status must be provided when selected applicants are interviewed for placement.

Note: Proof on income and assets must be provided when selected applicants are interviewed for placement.

Current Accommodation

What are your current accomodations?

If other, please specify:

How much is your rent payment?

What is the frequency of your payment?
 

Is heat included in your payment?

How many bedrooms does your household have?

Please describe your current living arrangements

If other, please describe:

Do you have a bathroom?

Do you have a kitchen?

Have you received a legal notice to end tenancy?

If YES, what date do you have to move by?

Note:  A copy of the notice to end a tenancy must be provided when selected applicants are interviewed for placement. This notice must be the Residential Tenancy Branch’s Notice to End Tenancy Form.

If you are currently housed and you are NOT under notice to move, please tell us why you want to move.

Please feel free to share any further details that will help us understand your situation: 
 

I confirm all information is true and complete. I have left nothing out that may be a factor in being offered an Aboriginal Housing Society of Prince George unit. I understand that false information or omission of required information will result in the cancellation of my application. I confirm I will provide all required references, landlord information, identification, and (if needed) financial records when I am interviewed for placement into an AHSPG unit.

Leave this empty:

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Signature Certificate
Document name: Housing Application Form
lock iconUnique Document ID: cc324f2ab1732782386fef167061127b79cb5ae9
TimestampAudit
July 22, 2021 4:43 pm PDTHousing Application Form Uploaded by Christina Verticchio - christinaverticchio@gmail.com IP 199.126.138.243
August 31, 2021 8:28 pm PDT Document owner info@ahspg.ca has handed over this document to christinaverticchio@gmail.com 2021-08-31 20:28:49 - 154.5.75.18