Fields marked with a * are required.
PLEASE COMPLETE ALL SECTIONS OF THE APPLICATION
3. Other Residents
4. PRESENT HOUSING INFORMATION
5. HOUSING HISTORY
6. HOUSEHOLD INCOME
TOTAL MONTHLY HOUSEHOLD INCOME (Total amount before deductions)
You must state all sources of income for each member of your household over the age of 16. Proof of income is required i.e.: photocopies of pay stubs and/or bank books showing monthly income deposits.
Pursuant to the Provincial / Municipal Freedom of Information and Protection of Privacy Act, I give my consent and authorization to Goodwill Niagara:
1. To make inquiries to verify the information given on this application and I authorize any person, corporation or any social agency having knowledge of any such required information to release the information to Goodwill Niagara. I agree to provide any supporting material required for my application.
2. To disclose the information given on this form to non-profit housing corporations, co-operatives, and other municipal, provincial, and federal departments and agencies that assist in the provision of affordable housing and social agencies providing social assistance to me and persons listed on this application.
3. I understand that if I have any arrears owing to any non-profit or co-operative housing provider and have not made acceptable payment arrangements, I will be deemed ineligible.
4. I understand that I must advise Goodwill Niagara of any changes in contact information and/or household composition within 10 days of the change or my application will be cancelled and I must reapply.