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 Trafalgar Cooperative Housing AssociationOffice: 2035 Trafalgar StreetVancouver, BC V6K 3S5 Dear Applicant:Enclosed is our Housing Application Form and Income Verification Form. Complete both and return them to:By Mail:Trafalgar Cooperative Housing Association2035 Trafalgar StreetVancouver, BC V6K 3S5You will only be contacted when we have an appropriate vacancy and if you meet the income level the co-op needs for that vacant unit.You must contact us in writing annually to keep your application active. Should any information on your application change once you have been put on our waiting list (e.g. address, income, phone numbers, family size) you must contact us in writing to inform us of the changes. If we have a vacancy and we cannot reach you by telephone, your name will be removed from our waiting list.The waiting time may be lengthy, although a vacancy can occur at any time.We look forward to hearing from you.Co-operatively, Membership CommitteeTrafalgarHousingCoop.TRAFALGAR COOPERATIVE HOUSING APPLICATIONA.Name of Principal Applicant __________________ Date of Birth date ____ month ____ year ____Current Address ______________________________________________________ ______________________________________________________Home Telephone Number ________________ Work Telephone Number _________________Cell ________________________ Email Address _______________________________ List All Current EmployersFor the Principal Applicant _________________________ For the Co-applicant ____________________Self-Employed ___________________________ Work Reference ______________________For the Applicant _________________________ For the Co-applicant____________________Self-Employed ___________________________ Work Reference ______________________For the Applicant _________________________ For the Co-applicant____________________Self-Employed ___________________________ Work Reference ______________________B. List all additional persons who will be residing with you and their relationship:NameRelationship Date of Birth (dd/mm/yy) Part-time Full Time1._______________________________________________________ 2._______________________________________________________ C. Type of housing unit you require (we attempt to match housing size with family need):Check all that apply:___ 2 Bedroom approximately 500 square feet (2605 West 5th)___ 2 Bedroom approximately 750 square feet (Trafalgar building-upper units)We are not accepting applications for 3 Bedroom units as we have an internal wait list. Number of motor vehicles and type: ___________________________________________If you own a pet(s), please state how many and what breed:____________________________________________________________________________What is your current housing situation? Rent Own Co-op Other: Specify:________________________________________________________________________Have you ever lived in a housing co-operative? ___________________________________If yes, which co-op(s) and where: __________________________________________List last two residences in the past ten years (your former landlord may be contacted as a reference if you are selected for an interview):1. Address _____________________________________________________________________________Landlord ____________________________________ Current phone number ___________Length of residence _______________________ Reason for leaving (or wanting to leave) ____________________________________________________________2. Address ____________________________________________________________________________Landlord ____________________________________ Current phone number ___________Length of residence _____________________ Reason for leaving ____________________________________________________________What type of volunteer work have you done recently? ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________What do you think are the advantages of living in a housing co-operative? ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________What personal attributes and skills do you possess that would make you a valuable co-op member? Please indicate any education and experience with group work, group decision-making, collaboration, management, computer literacy, numeracy used in volunteer or paid employment. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________Other: (please feel free to provide more information if you wish and additional paper):On which committee(s) will you volunteer?Finance Board Maintenance Membership Why? If I (and co-applicant) am/are accepted as members of Trafalgar Cooperative Housing Association I/we promise to participate by participating in committee work and attend general meetings.Signed: ______________________________________ Date: ____________________________________________________________________ Date: ______________________________Personal Information Protection Statement[to be signed with application form]I agree that the Trafalgar Cooperative Housing Association may keep the following information about me: financial information as requiredeligibility information to qualify for the supplementary Home Owner GrantCo-op census information, including a record of all residents in each unit for securityrelationship of co-applicant to applicant and date of birth of other occupants - if this is required to establish the size of unit for my household, based on Co-op occupancy standards.date of birth, only for purposes of conducting a credit check and reporting unpaid debts to a collection agency or credit bureau. whether I meet the age requirements for membership as set out in the Co-op's RulesI agree that this personal information may be made available to people in the following positions: Co-op auditormunicipal employees dealing with the Home Owner Grant (for grant application) Co-op lawyer designated Member Selection Committee Members – interviewers, Membership Chair and people responsible forapplications for the Home Owner Grant collecting signatures for the Home Owner Grantlandlord and other reference checksmaintaining secure filing and storage of personal information (both hard copy and computer) Board of Directorsonly if it is in connection with the Board's official dutiesI understand that Trafalgar Cooperative Housing Association may use the information to:contact me about this applicationdetermine my eligibility for housing and membership in the Co-opestablish the size of unit for my household, based on Co-op occupancy standards determine eligibility for supplementary Home Owner Grantensure safe evacuation of all household members in case of emergency conduct a credit check before accepting my application decide on any request for an internal move I understand that the Co-op will destroy personal information that it no longer needs. I have read and received a copy of this statement. Signed: ___________________________________ Date: ____________________________Signed: ___________________________________ Date: ____________________________All members of the household 16 years of age and older must sign this statement. Trafalgar Cooperative Housing AssociationINCOME VERIFICATION FORMName of Principal Applicant _________________________________Number of adults in family _________________________________________ Number of children residing with you _________________________________Please note that in all categories of income you must use the present gross monthly figures. You must list all sources of income except the Canada Child Tax Benefits, the BC Family Bonus, and Grants. (Please note – the Co-applicant is your spouse/partner). If you are considered for a unit, we will require the previous year’s income tax verification. ApplicantCo-ApplicantOthersSalary and/or commissionSelf-employed incomeEmployment insurancePensionsSocial assistanceChild support or alimonyOther: TOTAL FROM ALL SOURCESPlease indicate if you expect any significant changes in your income during the next 12 months, giving date, approximate increase or decrease and reason for such (e.g. retiring, having a baby, promotion, etc.). ______________________________________________________________________I/ We do hereby confirm that all income for all adult household members has been declared.Signed by all household members declaring income:____________________ _______________________ ___________________ Signature Print name in full Date____________________ _______________________ ___________________ Signature Print name in full Date ................
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