165 Sugar Maple Street, Kitchener, ON

Birth Date *

MM

DD

YYYY

Full Name *

First Name

Last Name

Phone Number *

(###)

###

####

What is your desired move-in date? *

MM

DD

YYYY

What is your current employment status? *

Employed

Self-Employed

Unemployed

Retired

Student

Do you have proof of income (pay stubs, bank statements, employment letter)? *

Yes

No

What is your estimated credit score? *

700+

650-699

600-649

Below 600

Current Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Current Landlord's Name *

First Name

Last Name

Do you or any occupants smoke? *

Yes

No

Do you have renter’s insurance or are you willing to obtain it? *

Yes

No

Are you willing to provide first & last month’s rent? *

Yes

No

Can you provide landlord & employer references? *

Yes

No