Apply Online

Note: Each adult 16 years of age or older who will live in your unit must complete an application.

Once the application is received, the co-op conducts a credit and landlord check. Your application is then forwarded to the Member Selection Committee who will contact you to schedule an interview. The purpose of the interview is to try to get to know you a little better. It also gives you the opportunity to ask questions of people who live here.

After the interview, your application is forwarded to the Board of Directors for final review and approval.

You can complete the online application below or download the application form in PDF version and drop it off in person.

Click here to download our application form in Word format


Online Application Form


Applicant Information


*First Name:

*Last Name:

*E-mail Address:

*Applicant's birth date(dd/mm/yy):

*Total number of adults (16+) in household:

Names of co-applicants:

Children (state name and age for each):

*Phone:

What size unit would you like?:
 1 bedroom 
 2 bedroom
 3 bedroom
 4 bedroom
Do you need a wheelchair accessible unit?:
 Yes   No
How did you hear about us?:
 Advertisement 
 Housing auth
 Bread & Roses Website
 CHF/COCHF
 Other
Did someone refer you? If so, tell us their name:


Co-Op Related Questions


*What do you think 'Co-Op living' means?

*Why would you like to live at Bread & Roses?

List any volunteer experiences or community activities that you consider significant:


Co-op members are encouraged to contribute some of their time to the running of the co-op...

Do you understand this expectation, and do you think you will be able to contribute your time to the running of the co-op?:
 Yes   No
Would you have difficulty living here if your neighbour was HIV positive or living with AIDS?
 Yes   No

Would you feel uncomfortable if your neighbour was...

Of a different ethnic background from yours?
 Yes   No
Of a different economic status from yours?
 Yes   No
Of a different sexual orientation than yours?
 Yes   No
Will you learn, live by, respect and help develop the bylaws of Bread and Roses and participate fully in the Co-op?
 Yes   No

Employment Information


IMPORTANT: All information in this section is kept strictly confidential

*S.I.N.:

Occupation:

Employer:

Employer's address:

Employer's phone #:

Gross monthly income:


Moving Date


*When would you like to move in?: (mm/dd/yyyy)


Housing Charge Assistance


Do you need to receive housing charge assistance in order to live at Bread & Roses?
 Yes   No
If you answered yes, please continue, otherwise skip to 'Past and present accommodation'

Status:
 Canadian Citizen   Landed Immmigrant  Valid Refugee Claimant
Has your local housing authority referred you?
 Yes   No

Past & Present Accommodation


Present address (include postal code):

Present Landlord:

Landlord's phone:

How long have you lived there?

Current rent per mth:

Are utilities included?
 Yes   No
Previous Landlord

Previous address (include postal code):

Previous Landlord's phone:

Years lived there?

List the names and phone numbers of any other housing co-op or non-profit that you have lived in before:

Comments(if any):

*Security Question(avoids spam):
Ten minus five =
Please inform me of specials or promotions: Yes  No

I declare that the information given on this application is full and correct and that it may be used to establish credit worthiness or good references.

I understand that if I am accepted as a member and upon move-in, I am required to pay a $15 non-refundable membership fee to the co-op.

I agree to the above statement







Copyright 2016 Bread and Roses Co-op Homes. All rights reserved. personal
Website by Adam Cooper Websites - Web Design & Websites in Kitchener Waterloo, Cambridge, Guelph, Hamilton Ontario