Brooks Housing Society » Pre-Qualification Housing Application

Pre-Qualification Application

Prairie Village is an affordable housing initiative managed by the Brooks Housing society. Income guidelines apply and eligibility is based Core Need Income Threshold levels which regulated by the Alberta Government to ensure fair and accessible housing for all qualified applicants.

Who is eligible?

Application Form

Please note the acceptance or refusal of an applicant is at the sole and absolute discretion of management. Qualifying applicants will be contacted for an interview to finalize documentation.

Once accepted you will be required to pay first months rent and a security deposit equal to one months rent.

Download a PDF Application Form

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Applicant Information

Name(Required)

First Last

Phone(Required)

Email(Required)

Drivers License Number(Required)

License Plate Number(Required)

Make and Model of Vehicle(Required)

Please upload a copy of your government issued ID:(Required)

Drop files here or

Max. file size: 2 MB, Max. files: 1.

Employment Information

Current Employer(Required)

Company Address(Required)

Street Address City Province Postal Code

Date of Employment:(Required)

MM slash DD slash YYYY

Hours worked per week:(Required)

Total Monthly pay:(Required)

Hourly Wage:(Required)

Have you received any other sources of income in the past 12 months?(Required)

Yes

If yes, please note your additional sources of income:(Required)

For Example, Newell Housing, Canada Student Loan, CPP, EI, AISH, WCB, Child Tax Benefit, Child Support/Alimony, Penision, Veteran's Pension, etc.

Click the "+" to the right to add additional rows.

Source of Income

Dates (From/To)

Total Recieved

Please upload 3 most recent pay stubs or letter of verification from your employer:(Required)

Drop files here or

Max. file size: 2 MB, Max. files: 3.

Please upload a copy of your most recent Income Tax Return:(Required)

Drop files here or

Max. file size: 2 MB, Max. files: 1.

Current Address and Landlord

Current Address(Required)

Street Address Address Line 2 City Province Postal Code

Do you own or rent your present accommodation?(Required)

Own

Rent

Landlord's Name(Required)

First Last

Landlord's Phone Number(Required)

Current monthly Rent or Mortgage payment?(Required)

Current monthly average utility payment?(Required)

Current length of stay and reason for leaving:(Required)

If you have been given notice to vacate, please submit a copy of the notice stating the reason for eviction.

Max. file size: 2 MB.

Rental Request

Number of bedrooms requested:(Required)

1 Bedroom

2 Bedrooms

3 Bedrooms

Do you have a co-applicant?(Required)

Will there be an additional Adult living at the residence?

Yes

Additional Residents

List all persons who will be living with you:(Required)

Click the "+" to the right to add additional rows.

Full Name

Relationship to Applicant

Age

Is any member of your family physically handicapped?(Required)

Yes

Do you require a unit with a wheelchair accessibility?(Required)

Yes

Do you require a ground floor unit?(Required)

Yes

Co-Applicant Information

Additional Adult living at the residence.

Co-Applicant Name(Required)

First Last

Co-Applicant Phone(Required)

Co-Applicant Email(Required)

Please upload a copy of your co-applicant's government issued ID:(Required)

Drop files here or

Max. file size: 2 MB, Max. files: 1.

Co-Applicant Employment Information

Current Employer(Required)

Company Address(Required)

Street Address City Province Postal Code

Date of Employment:(Required)

MM slash DD slash YYYY

Hours worked per week:(Required)

Total Monthly pay:(Required)

Hourly Wage:(Required)

Has your co-applicant received any other sources of income in the past six months?(Required)

Yes

If yes, please note your co-applicant's additional sources of income:(Required)

For Example, Newell Housing, Canada Student Loan, CPP, EI, AISH, WCB, Child Tax Benefit, Child Support/Alimony, Penision, Veteran's Pension, etc.

Click the "+" to the right to add additional rows.

Source of Income

Dates (From/To)

Total Recieved

Please upload 3 most recent pay stubs or letter of verification from your co-applicant's employer:(Required)

Drop files here or

Max. file size: 2 MB, Max. files: 3.

Please upload a copy of your co-applicant's most recent Income Tax Return:(Required)

Drop files here or

Max. file size: 2 MB, Max. files: 1.

Consent(Required)

Confidentiality Waiver

I have asked the staff to facilitate this application on my behalf. I understand this requires the staff to contact a third party eg. Newell Housing, Alberta Works or other people/agencies noted on this application. I give my consent and permission to the staff to make contact related to this application. I give consent to any mentioned agency to release all relevant requested information to Brooks Housing Society staff.

The information provide on this form is collected under the authority of the Society's Act and is in accordance with the Personal Information and Privacy Act. This information is being collected for the purpose of determining and verifying tenant eligibility for the Brooks Housing Society.

I understand that this application does not constitute an agreement on the part of Brooks Housing Society, or its agents to provide the applicant with rental accommodation.

I further acknowledge the right of Brooks Housing Society, or its agents at any time prior to the execution and delivery, to me of a lease hereby applied for, to withdraw, revoke or cancel, without penalty or liability for damages or otherwise any acceptance or approval of the application previously made or given. Any false statements shall cancel any further consideration of my application.

I further agree that I am obligated to advise Brooks Housing Society, or its agent, in writing of any changes in family composition, gross family income, assets, employment or change of address, should they occur.

I am confirming that the applicant agrees to the following terms and conditions.

This field is for validation purposes and should be left unchanged.

Pre-Qualification Application

Prairie Village is an affordable housing initiative managed by the Brooks Housing society. Income guidelines apply and eligibility is based Core Need Income Threshold levels which regulated by the Alberta Government to ensure fair and accessible housing for all qualified applicants.

Application Form

Please note the acceptance or refusal of an applicant is at the sole and absolute discretion of management. Qualifying applicants will be contacted for an interview to finalize documentation.

Applicant Information

Employment Information

Current Address and Landlord

Rental Request

Additional Residents

Co-Applicant Information

Co-Applicant Employment Information

Our Address

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