Online Membership Application – Co-Op Housing in Liverpool Nova Scotia

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Lawrence Street Project
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Who We Are
Lawrence Street Project
More
Contact Us

Trestle Way Neighbourhood

APPLICATION FOR MEMBERSHIP – HOUSING

Location RequestedPlease checkTrestle Trail Way

Unit size requestedPlease check1 Bedroom2 Bedrooms3 Bedrooms

Secondary request unit sizePlease check: If you are eligible for more than one unit size, please complete this section. If the applicant’s preferred unit is not available and they qualify for another unit size the second choice will be considered.1 Bedroom2 Bedrooms3 BedroomsDo not want another unit size

Do any persons living in your household require a wheelchair accessible unit?The Trestle Way Neighbourhood units are all fully universal and adaptable with two units being fully barrier free and include wheelchair accessible common spaces.YesNo

Do any persons living in your household require an assisted mobility unit?YesNo

Are all individuals applying for membership able to live independently without outside supports?YesNo

If you require outside supports to live independently, please describe?

Queens Neighbourhood Co-operative Housing Ltd Trestle Way Neighbourhood is a non-smoking residence.Please check yes to acknowledging that there is no smoking indoors and smoking is only allowed at designated areas outdoors.Yes

Do you or the co-applicant (if applicable) identify as an older adult or senior (58 Years of age or older)?YesNo

Applicant’s full name

Email Address

Date of Birth

Phone

Social Insurance Number

Co-applicant’s full nameIf applicable

Co-applicant’s Email AddressIf applicable

Co-applicant’s Date of BirthIf applicable

Co-applicant’s PhoneIf applicable

Co-applicant’s Social Insurance NumberIf applicable

Number of people that will be living in the housing unit – including children

Full Name - 1

Relationship - 1

Date of Birth - 1

Full Name - 2

Relationship - 2

Date of Birth - 2

Full Name - 3

Relationship - 3

Date of Birth - 3

Full Name - 4

Relationship - 4

Date of Birth - 4

Full Name - 5

Relationship - 5

Date of Birth - 5

Full Name - 6

Relationship - 6

Date of Birth - 6

QNCH pet policy is as follows:

Each household is allowed only one pet.
Cats are allowed.
Dogs 35 pounds and under are permitted.
Dogs over 35 pounds are not permitted unless they are registered service animals. Proof of registration is required.
All pets must be spayed or neutered.
All pets must be up to date on vaccinations. QNCH may request a copy of an up-to- date vaccination record at any time.
Residents must ensure their pets do not cause unreasonable disturbances to other households, such as continuous or excessive barking.

Additionally, all pets must meet Region of Queens Municipality Animal By-Law for approved household pets. Please refer to the Bylaws in your Municipality for details on licencing, prohibited animals and ownership requirements:

www.regionofqueens.com/municipal-services/bylaws/dog-bylaws

Residents are required to provide property management with confirmation of the pet residing in the household.

Name and type of pet

Confirm pet is spayed or neuteredYes

Confirm pet is up to date on vaccinationsYes

Present Address

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal code

Country

How long have you lived there

Housing charge or rent amount

CAD

Landlord

Reason for leaving

Previous Address

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal code

Country

How long did you live there

Housing charge or rent amount

CAD

Landlord

Reason for leaving

Applicant’s employment

Include all sources of income

Number of Employersif you have multiple employers or income sources, please select a number

Occupation - 1

Employer - 1Name & contact. Including phone number & address

Length of Employment

Gross monthly incomeMonthly pay before tax

CAD

Occupation - 2

Employer - 2Name & contact. Including phone number & address

Length of Employment - 2

Gross monthly income - 2Monthly pay before tax

CAD

Occupation - 3

Employer - 3Name & contact. Including phone number & address

Length of Employment - 3

Gross monthly income - 3Monthly pay before tax

CAD

Occupation - 4

Employer - 4Name & contact. Including phone number & address

Length of Employment - 4

Gross monthly income - 4Monthly pay before tax

CAD

Co-applicant’s employment

Include all sources of income

Co-applicant’s Number of Employersif you have multiple employers or income sources, please select a number

Co-applicant’s Occupation - 1

Co-applicant’s Employer - 1Name & contact. Including phone number & address

Co-applicant’s Length of Employment - 1

Co-applicant’s gross monthly income - 1Monthly pay before tax

CAD

Co-applicant’s Occupation - 2

Co-applicant’s Employer - 2Name & contact. Including phone number & address

Co-applicant’s Length of Employment - 2

Co-applicant’s gross monthly income - 2Monthly pay before tax

CAD

Co-applicant’s Occupation - 3

Co-applicant’s Employer - 3Name & contact. Including phone number & address

Co-applicant’s Length of Employment - 3

Co-applicant’s gross monthly income - 3Monthly pay before tax

CAD

Co-applicant’s Occupation - 4

Co-applicant’s Employer - 4Name & contact. Including phone number & address

Co-applicant’s Length of Employment - 4

Co-applicant’s gross monthly income - 4Monthly pay before tax

CAD

Income verification

Applications will not be complete until the below proof of income is provided.

Needed Documentation: *I have attached one of the following documents to provide proof of income:Most recent paystub with year-to-date income3 most recent paystubsLetter from employer confirming annual salary.Proof of other income.

Upload files

Drag and Drop (or) Choose Files

Notice of assessmentI have attached my notice of assessment (NOA) for the 2024 or 2025 tax yearYes

If you do not have your notice of assessment, please contact Canada Revenue agency either online or by phone:

https://www.canada.ca/en/revenue-agency/services/tax/individuals/topics/about-your-tax-return/a-copy-your-notice-assessment-reassessment.html

Phone: 1-800-959-8281

Note

The co-op does not guarantee parking and parking spots will be limited to one per household.

Make

Year / Color

License Plate Number

Province

I/we know that I/we have the right to verify the information about me/us held by credit reporting agencies, that the landlord and its agents are entitled to rely on such credit reports as being correct, and I/we release any claim I/we may have arising from reliance on that information. I/we hereby give irrevocable permission to the Landlord or its agents to obtain at any time a consumer/credit report about me/us, to contact previous landlords to obtain information about my/our previous tenancies, to contact agencies that provide landlord information, to contact my references, and to take any other reasonable steps necessary to assess this rental application or for any amendment or renewal of my/our tenancy.

Confirm *Yes

Applicant’s full name *

Date *

Co-applicant’s full nameIf applicable

Date

Credit report authorization and release

Authorization is hereby granted to Queens Neighbourhood Co-operative Housing to obtain a standard factual data credit report through a credit reporting agency. My signature below authorizes the release to the credit reporting agency a copy of my credit application and authorizes the credit reporting agency to obtain information regarding my employment and outstanding credit accounts (mortgages, auto loans, personal loans, charge cards, credit unitions, etc.). Authorization is further granted to the reporting agency to use a photocopy reproduction of this authorization if necessary to obtain any information regarding the above-mentioned information. Any reproduction of this credit report authorization and release made by reliable means (for example. Photocopy, facsimile, or email) is considered an original.

Consent *

Yes, I agree.

Applicant

Co-applicant

If applicable

Applicant’s full name

Co-applicant’s full name

Applicant’s Social Insurance Number

Co-applicant’s Social Insurance Number

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal code

Country

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal code

Country

If you would like to submit a printed application or request additional information, please do so to:

P.O. Box 99 Liverpool

Nova Scotia

B0T 1K0

Email : applications@qnch.ca

Contact Info

Email: info@QNCH.ca

Policies

Accessibility Policy
Privacy Policy

Acknowledgments

Land Acknowledgement