Affordable Housing Initial Application
For Aqanttanam Housing Society

**Please provide as much information as possible, and fill out the questions completely. A lack of information will result in a longer processing time**

Email address *
Today's Date
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Applicant's Name
Your answer
Applicant's Phone Number *
Your answer
Maiden Name
Your answer
Date of Birth
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YYYY
Native Ancestry?
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Are you employed?
If Yes, How much is your GROSS MONTHLY INCOME?
Your answer
Are you receiving any other money? Social assistance, EI, CPP, PWD, etc. If "yes" please indicate which one below
Your answer
Personal Reference Name & Number
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Do you have dependent children? If "yes" please list them below
Your answer
Where are you currently living?
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Do you have a spouse?
Spouse's Name
Your answer
Spouse's Date of Birth
Your answer
Spouse's Native Ancestry
Phone Number
Your answer
Are you Employed?
If Yes, How much is your GROSS MONTHLY INCOME?
Your answer
Are you receiving any other money? Social assistance, EI, CPP, PWD, etc. If "yes" please indicate which one below
Your answer
Do you have any pets? If "yes" please list them all and indicate if they are a cat or dog
Your answer
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