Apply For Housing - Gorge View Society

Purpose of this form

This form collects personal information in accordance with section 26(c) and 33.2(a) of the Freedom of Information and Protection of Privacy Act. GVS will use this form to determine your eligibility for housing at Chown Place, based on:
-Your income
-Family composition/age
-Housing needs
-Funder policies
Your details will be kept for a year. After a year, please resubmit a housing inquiry form to keep your application active.

Contact Info

Your Name(s):

Your Email Address:

Phone Number

Current Address

Family Information

Are you registered with B.C. Housing?

Yes No

Adults in household (1 or 2):

Children in household (min. 3 nights/week):

SENIORS: Are you 60 years of age or older

Yes No

Adults' dates of birth:

Children's dates of birth:

Financial Information

Occupancy is restricted to households in need as determined by income and assets.

Estimated income (specify monthly or annual):

Under BC Housing guidelines, your assets must be less than $100,000 and include the following:
-Stocks, bonds, term deposits, mutual funds, cash, and real estate equity, net of debt.
-Business equity in a private incorporated company including cash, GICs, bonds, stocks or real estate equity.

Are your assets below $100,000?

Yes No

Notice to End Tenancy

Have you ever received an eviction notice?

Yes No

Please elaborate:

Independent Living

Are you able to care for your daily needs without skilled nursing or assistance?

Yes No

Please elaborate:

Are there any issues that you struggle with in caring for your daily needs?

Do you have any special requirements or features that you may need in your housing related to mobility or health conditions (ex: access for scooter/wheelchair inside/outside, stairs, walk-in showers, etc.)

Do you require parking?

Yes No

*Please note: Parking is limited and an extra cost of $50.00 per month. Parking spots are not guaranteed

Current Housing Situation

This information helps us assess your current housing need.

Do you:

Rent Own Share Other

Please explain:

Do you pay 30% or more of your gross income on rent?

Yes No

Monthly rent ($):

Do you pay for heat and hot water separately?

Yes No

Have you received a legal Notice to End Your Tenancy at your current place of residence?

Yes No

Date you need to move by:

Please tell us why and when you want to move from your current residence:

Other Information

What is the earliest date you are looking to rent?

What does community mean to you?

The form was sent successfully.

An error occured.