.: Slemon Park Corporation | Residential Housing :.

Unit Desired:
Occupancy Date
Reason for Moving:

	First Name:	Middle Name:	Last Name:	DOB:
Applicant:
Co-applicant:

	Home Phone:	Cell Phone:	Work Phone:	Other:
Applicant:
Co-applicant:

Other Residents Names:	Relationship:	DOB:
1
2
3
Pets:	Breed:

	Present Address:	Dates:	Landlord:	Phone Number:
Applicant:
Co-applicant:

	Previous Address:	Dates:	Landlord:	Phone Number:
Applicant:
Co-applicant:

Applicant:
Present Employer:	Supervisor:	Phone:	Dates:	Annual Salary:

Other Income:
Total Annual Income:

Co-applicant:
Present Employer:	Supervisor:	Phone:	Dates:	Annual Salary:

Other Income:
Total Annual Income:
Total Annual Household Income:

	Previous Employer:	Phone:	Supervisor:	Dates:
Applicant:
Co-applicant:

Reference Names:	Phone:	Occupation:
1
2

In Case of an Emergency Contact:	Phone:	Address:	Relationship:
Applicant:
Co-applicant:

Comments:

I, (we) certify that the above information is correct and I understand that this application may be revoked if any information upon this application is found to be incorrect. I authorise you to contact any references listed on this application.
Signatures:

Applicant:
Co-applicant:		Date:

SPC Approval

Yes No

SPC:

Contact:
Slemon Park Corporation
Terry Arsenault
PO Box 90
30A Aerospace Blvd.
Slemon Park, PEI
C0B 2A0
Telephone: 902-432-1740
Facsimile: 902-888-3078
E-Mail: tarsenault@slemonpark.com

SLEMON PARK CORPORATION | spc@slemonpark.com | 902.432.1700