Application Form – Marigold Housing Co-op

1Applicant Information

2Household Information

3Current Housing Information

4Past Housing Information

5Employer Information

6Questionnaire

7Keeping your Application Active

8Income Verification

9Credit Report Authorization

Hidden
form_type*
Primary Applicant Information
Please enter the information for the primary applicant.
Name*
First Last
Date of Birth*
Current Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
This application includes a Co-Applicant*
- Yes
- No
Select Yes to enter Co-Applicant information.
Co-Applicant Information
Please enter the information of the co-applicant.
Name*
First Last
Date of Birth*
Co-Applicant Current Address is the same as Primary Applicant*
- Yes
- No
Current Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone
Email

Current Housing Information
Please fill out current housing information for both the primary and co-applicant. Reference checks will be conducted.
Primary Applicant Current Housing Information
Current Landlord*
First Last
Current Landlord Phone*
Current Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Length of Stay*
Reason for Leaving*
Monthly Rent / Mortgage*
Enter current monthly rent / mortage.
Utility Charges*
Enter current monthly utility charges.
Co-Applicant Current Housing Information
Co-Applicant Current Housing Information is the same as Primary Applicant*
- Yes
- No
Current Landlord*
First Last
Current Landlord Phone*
Current Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Length of Stay*
Reason for Leaving*
Monthly Rent / Mortgage*
Enter current monthly rent / mortage.
Utility Charges*
Enter current monthly utility charges.

Previous Housing Information
Please fill out past housing information for both the primary and co-applicant. Reference checks will be conducted.
Primary Applicant Previous Housing Information
Previous Landlord*
First Last
Previous Landlord Phone*
Previous Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Length of Stay*
Reason for Leaving*
Monthly Rent / Mortgage*
Enter current monthly rent / mortage.
Co-Applicant Previous Housing Information
Previous Landlord*
First Last
Previous Landlord Phone*
Previous Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Length of Stay*
Reason for Leaving*
Monthly Rent / Mortgage*
Enter current monthly rent / mortage.

Employer Information
Primary Applicant Employer Information
Occupation*
Employer Name*
Employer Phone*
Employer Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Co-Applicant Employer Information
Occupation*
Employer Name*
Employer Phone*
Employer Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Other References (Not Relatives)
Primary Applicant References*
Name Relationship Phone

Click the plus (+) button to add more references.
Co-Applicant References*
Name Relationship Phone

Click the plus (+) button to add more references.

Keeping Your Application Active
1. You must contact Marigold Co-op every 6 months to notify/update the co-op that you are still interested in becoming a member. You must notify the co-op of any changes to your original application, i.e., change in income, family size, phone number, etc. Updates can be dropped off in person at 3950 Columbine Way during office hours (Tuesdays and Thursdays from 4pm to 6pm) or put into the co-op mail box at the same address. Updates can also be emailed to the co-op, marigoldco-op@shaw.ca, or mailed via Canada Post. Applications not updated every 6 months become obsolete.
2. Marigold Co-op cannot advise you of where you are on the wait list, how long it will take until a unit becomes available, or how long you might stay on the waitlist. Please do not contact the co-op for this information. Requesting this information is not considered an update.
I/we understand that income verification will be required should we be contacted for an interview for possible membership.

I/we understand that only members of MARIGOLD HOUSING CO-OPERATIVE may occupy a housing unit and I/we hereby apply for membership to this Co-op.

I/we understand that MARIGOLD HOUSING CO-OPERATIVE is formed for the purpose of providing housing to its members and that membership includes the responsibility to participate in the operation and the maintenance on or in the Cooperative.

I/we understand that accommodation in MARIGOLD HOUSING CO-OPERATIVE depends on being accepted for membership in the Co-operative and that I/we may be interviewed for membership at a later date.

I/we declare that all information in this application is correct and hereby authorize the Co-operative to verify any or all of the information contained herein, including contacting current and former landlords, personnel references, and employer, and to perform a credit check at the discretion of the Co-operative.
Name*
First Last
Date*
I agree to the above privacy policy.*
Name*
First Last
Date*
I agree to the above privacy policy.*

Income Verification
Name of Principal Member / Applicant*
First Last
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). Income of dependents over the age of 19 is also required.
Salary & / or Commission Self-Employed Income Employment Insurance Pensions Social Assistance Child Support or Alimony Other Total
Please 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 (i.e. retiring, having a baby, promotion, etc.).
Primary Applicant's Current Employer*
Co-Applicant's Current Employer*
Primary Applicant*
First Last
Date*
*
I/We do hereby confirm that all income for all adult household members has been declared
Co-Applicant*
First Last
Date*
*
I/We do hereby confirm that all income for all adult household members has been declared

Credit Report Authorization
In conjunction with your application for membership in the Marigold Housing Co-operative, you are required to agree to allow the owner to obtain credit information. Please indicate your concurrency by acknowledging the Statement below.

I/we certify that the information provided on our Application is true and correct and I/we agree to allow Marigold Housing Co-operative Inc., or its agent, to conduct such credit investigations as may be required in conjunction with the Application, and from time to time, as may be required under my/our tenancy agreement.
Date*
Primary Applicant*
First Last
Witness*
First Last
Primary Applicant*
First Last
Witness*
First Last
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.

First Name	Last Name	Date of Birth	Relationship to applicant	For children – do they reside Full Time or Part Time with you? If Part Time, what percentage?

Name	Age	Type	Spayed / Neutered?

Marigold Housing Co-op

Membership Application Form

Membership Application

Primary Applicant Information

Co-Applicant Information

Household Information

Other Considerations

Pets

Current Housing Information

Primary Applicant Current Housing Information

Co-Applicant Current Housing Information

Previous Housing Information

Primary Applicant Previous Housing Information

Co-Applicant Previous Housing Information

Employer Information

Primary Applicant Employer Information

Co-Applicant Employer Information

Other References (Not Relatives)

Questionnaire

Keeping Your Application Active

Income Verification

Credit Report Authorization

Salary & / or Commission	Self-Employed Income	Employment Insurance	Pensions	Social Assistance	Child Support or Alimony	Other	Total