Pheasant Meadows Cooperative Application for Membership and Housing
Applicant First Name *
Your answer
Applicant Last Name *
Your answer
Email Address *
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Phone *
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Alternate Phone
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Address 1 *
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Address 2
Your answer
City *
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Province *
Postal Code *
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Date of Birth *
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DD
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YYYY
Applicant - Name of employer or source of income (e.g. social assistance, CPP, OAS) *
Your answer
Applicant - How many years with current employer? *
Applicant Gross MONTHLY income each MONTH. *
Your answer
Co-Applicant First Name
Your answer
Co-Applicant Last Name
Your answer
Email
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Phone
Your answer
Alternate Phone
Your answer
Address 1
Your answer
Address 2
Your answer
City
Your answer
Province
Postal Code
Your answer
Date of Birth
MM
/
DD
/
YYYY
Co-Applicant - Name of employer or source of income (e.g. social assistance, CPP, OAS)
Your answer
Co-Applicant - How many years with current employer?
Co-Applicant Gross MONTHLY income each MONTH.
Your answer
All Other Household Gross MONTHLY Income each MONTH.
Your answer
Other Household Member 1 Name
Your answer
Relationship to Applicant
Your answer
Date of Birth
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DD
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YYYY
Age (If child is less than 1 years old please round up to a whole number of 1)
Your answer
Sex
Other Household Member 2 Name
Your answer
Relationship to Applicant
Your answer
Date of Birth
MM
/
DD
/
YYYY
Age (If child is less than 1 years old please round up to a whole number of 1)
Your answer
Sex
Do you expect the size of your family to change? *
If Yes, please explain
Your answer
How many people live in your current residence? *
Please explain if this is different from the number of people who you expect to be living in your unit in the Co-op, should you be accepted.
Your answer
How long have you lived at your current address? *
If you lived there less than 2 years, please give your previous address and how long you lived at this address.
Your answer
How much rent do you pay per month? *
Your answer
Landlord’s name *
Your answer
Landlord's Phone Number *
Your answer
Do you have a pet? *
The Co-op has a pet policy that allows 2 spayed/neutered pets. No aggressive breeds. Exotic pets need to be approved by the Board.
Required
If Yes, what type and dog breed (if applicable)?
Your answer
Are there any smokers in your household (including yourself?) *
Have you ever lived in a housing cooperative? *
If yes, please specify the name of the Co-op
Your answer
Co-op Reference Name
Your answer
Co-op Reference Phone Number
Your answer
On which of the following committees will you participate if you are a selected member? *
Required
Present Accommodation *
Pheasant Meadows Housing Cooperative requires as much specific information on your present housing as you can provide. Most of the following section can be answered by making a selection. Feel free to fill in the additional comments section with any additional information that may assist us in determining your requirements.
Member participation is required and is a condition for being accepted at our Co-op. Members are required to contribute a minimum of 2 hours per month. If approved for membership, will you fulfill this commitment? *
Additional Comments
Your answer
Acknowledgement and acceptance of Membership Requirements *
We understand that only the members of Pheasant Meadows Co-operative Housing may live in the co-op and we apply for membership, as set out below. We understand that, if the co-op accepts us for membership and offers us a unit, we must buy a share purchase of $3,500 for the principal member and $10 for each associate member. If accepted into membership, we agree to be bound by and comply with the Rules and Occupancy Agreement and Policies of the Co-op in force and as amended from time to time. We declare that all the information provided in this application is correct. We give the Co-op permission to verify any or all of this information, and to perform a landlord check and credit check. We understand that acceptance for membership also depends on the Co-op obtaining satisfactory results from a credit check.
Required
Are you human? If so, what is two plus 69? *
Your answer
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