Online Rental Application Form Or you can fill the information on the form below This is an application to rent: Your Name: Date of Birth: Tel: Your Email: Current Address: City: Dates of Tenancy: Name of Landlord: Landlord Phone: Reason for Leaving: Additional Occupants: Name: Age: Name: Age: Name: Age: Pets:YesNo Describe: Smoking:YesNo Describe: Employment Status & Income Verification: Occupation: Wage: Company: How long have you worked at this company?: Other income description (eg. Disability, Income Assistance, Savings): Vehicle Information: Make/Model: Year: References: 1. Name: Phone: Relationship (previous landlord, employer): 2. Name: Phone: Relationship (previous landlord, employer): I hereby state that the information contained herein is true and I authorize my References as listed above to release information regarding my employment and/or past/current tenancies. I also authorize a credit check to be conducted.