Welcome to Legion Manor Victoria | Apply Online - Supportive Housing Application

Application for Tenancy - Supportive Housing

Legion Manor

To download a PDF (printer-friendly) version of this application, click here.

General Information

Name of Applicant #1

Date of Birth

Marital Status

Name of Applicant #2

Date of Birth

Marital Status

Total Monthly Income ($)

Address

Postal Code

Phone Number

# of years in B.C.

In case of Emergency (other than joint occupant)

Name

Address

City

Postal Code

Phone Number

Doctor Contact Information

Name

Address

City

Postal Code

Phone Number

Present Accommodation

Number of Rooms?

Present Monthly Rent

Is it furnished?

Yes No

Does it include heat?

Yes No

Are light and power included?

Yes No

Are you under notice to vacate?

Yes No

References

Name

Address

Phone Number

Name

Address

Phone Number

Other Information

Are you a Veteran? Veteran status is not required.

Yes No

Are you a Legion member? Legion membership is not required.

Yes No

If yes, Branch #

Do you have any special dietary needs or food allergies?

Yes No

If yes, please describe:

Is parking required?

Yes No

Applications will not be considered unless all the questions have been answered. All accomodations are one-bedroom suites.

Declaration

I/we understand that this is not a contract and does not bind either party. By submitting this application online, I state that the foregoing information is full, true and complete to the best of my/our knowledge.I/we have no objections to discreet inquiries being made for the purpose of verification.

My/our state of health is as follows: (Excellent, Very Good, Good, Fair, Poor)

Person #1

Excellent
Very Good
Good
Fair
Poor

Person #2

Excellent
Very Good
Good
Fair
Poor

I/we verify the above is correct to the best of my knowledge.

Yes No

Please Note

Applications will not be considered unless all the questions have been answered. Those accepted will be placed on a waiting list. All accomodations are one-bedroom suites. An applicant, on being notifed of a vacancy and accepting it, is required to submit a security deposit of $500. This amount, or the minimum as laid down by the BC Housing Management Comissions. Cheques are to be made payable to the South Vancouver Island Zone Housing Society.

Should you move from the address shown on the application form and are still interested in remaining on the list for accomodation, please advise the Placement Officer of your new adress and telephone number in writing.

Name of Submitter

Email Address