Home - Kehilla Montréal

Identification

First name*

Last name*

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Primary phone*

Work Phone

(if applicable)

Email*

Immigration status*

Canadian citizen
Permanent Resident

Information on current living situation

Number of persons in the dwelling*

Number of adult(s)*

Number of children (under 18)*

Household composition

Name*

First Last

Relationship*

Gender*

Date of birth*

Name*

First Last

Relationship*

Gender*

Date of birth*

Name*

First Last

Relationship*

Gender*

Date of birth*

Name*

First Last

Relationship*

Gender*

Date of birth*

Name*

First Last

Relationship*

Gender*

Date of birth*

Name*

First Last

Relationship*

Gender*

Date of birth*

Name*

First Last

Relationship*

Gender*

Date of birth*

Name*

First Last

Relationship*

Gender*

Date of birth*

Name*

First Last

Relationship*

Gender*

Date of birth*

Name*

First Last

Relationship*

Gender*

Date of birth*

Hidden

Do you require a dwelling that is adapted for a handicapped person?*

Current rent*

Current dwelling size*

Amenities included in current lease*

electricity
heating
hot water
parking
refridgerator/stove
none
other

Other*

Current borough of residence*

Other*

How long have you been living at your current address?*

Landlord name*

First Last

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone*

Source(s) of revenue (check all that apply)*

Employment
Pension
Social assistance
Family benefits

Occupation (if applicable)*

Occupation of partner or spouse (if applicable)*

Employer Information

Company name*

Contact person*

First Last

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone*

Date of hire*

Hidden

Total household revenue (all persons 18+)*

By selecting this box I attest that all the information provided and contained herein is true and accurate.*

Confirm

Any falsification of information can result in a rejection of this application. We will contact you to request supporting documentation at a later date. All applications will be time-stamped upon receipt and processed accordingly. Please know that the submission of this application does not guarantee applicants a unit within the building.

Comments

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

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Identification

Information on current living situation

Household composition

Employer Information