Housing - Rowe House Application

  • Applicant
  • Income Information
  • Reason for Move
  • Complete

Prospective tenants must be employed full or part time, or attending school or training. This application form is designed to collect specific information from applicants seeking affordable housing. Nanaimo Youth Services Association will use this information to determine your eligibility for housing at Rowe House. Please answer all questions. If you have questions regarding completion of this form call us at (250) 753 - 3212 and we will be happy to help you.

A. Applicant
Gender
Your preferred pronouns
Are you receiving Disability?
B. Residency History

Please list your address(es) for the past 3 years. 

Include Address, From Date, To Date, Name of Landlord and Landlord Phone

Have provided the contact information from your previous 3 landlord?
Option to upload landlord or personal references
One file only.
56 MB limit.
Allowed types: jpg, jpeg, png, pdf, docx.
Permission to share your contact information with HIFIS

Permission to share your contact information with the Homeless Individuals and Families Information System (HIFIS) for Nanaimo.