Application Form | Eastwood Housing Coop

Name

First

Last

Address:

Home Phone:

Mobile Phone:

Email

Family Members:

Please include full names, ages, and relation to applicant (spouse, children, etc.)

Present Living Arrangements:
Include present address, length of time at this residence, name of current landlord and address. Also include addresses lived in the past 3 years.

Employment:
Occupation, Employer, Length of time, income.

Spouse Employment:
Occupation, Employer, Length of time, income.

Do you have pets?
Yes
No

Are your dog and/or cats spayed or neutered?:
Yes
No

If not, do you agree to have this done in a reasonable time after joining the co-op?:
Yes
No

All members in the co-operative must assist in its operation by participating on one or more committees. Are you willing to do so?
Yes
No

Character references:
Please include two employer character references (names and phone numbers)

Reference Information:
OK
References must be received in writing or via email. Your application will not be processed until these are received. Please note that references cannot be a relative.

Do you certify that all the information above is true to the best of your knowledge?
Yes

Current Date:

Applicaton Form