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Short Term Housing
Society of Hope
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* Indicates required question
Email
*
Your email
Full Name (first and last)
*
Your answer
Date of Birth
*
Your answer
Agency (Referred by)
*
Your answer
Contact number
*
Your answer
Are you a Canadian Citizen or A Permanent Resident
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Yes
No
Other:
Required
List all other household members that will be residing with you and their relationship to you (full names and dates of birth)
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Your answer
Do you have any Pets
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Your answer
If yes, what kind
Your answer
Current housing situation
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Your answer
Gross monthly income
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Your answer
What is your income source
*
Employment
Income Assistance
Employment Insurance
Pensions
Other ( Specify)
References - name and contact number- Landlord, Previous Landlord and Personal (whichever is applicable) Please provide at least 2
*
Your answer
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