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Online Apartment Application
  1. Application must be completed in full, prior to processing
  2. The application form does not bind any of the parties. The information in this application will be kept confidential

Step 1 of 3
Last Name (*)
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First Name (*)
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Home Phone # (*)
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Street Address (*)
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City (*)
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Province
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Postal Code (*)
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Spouse Information (if applicable)
Spouse Name
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Living Preferences
Northwood Manor
Northwood Tower
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Almon Place
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Assisted Living
Starting at $1,995.00
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Will you require parking? (*)
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How did you hear about Northwood Apartments?
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Step 2 of 3

Please add values without dollar signs ($) or commas (,)
Old Age Security
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Provincial Assistance
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War Veterans
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Disabled Pension
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Canada Pension
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Other Pensions
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Calculate
Total Income
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Step 3 of 3
Family Doctor Phone # (*)
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Family Doctor (*)
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Date of Birth (MM/DD/YY) (*)
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Health Card Number (*)
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Spouse Information (if applicable)
Family Doctor Phone #
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Family Doctor
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Date of Birth (MM/DD/YY)
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Health Card Number
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Persons to be notified incase of emergency
Option 1
Name (*)
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Relationship (*)
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Postal Code (*)
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Telephone (*)
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Option 2
Name
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Relationship
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Postal Code
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Telephone
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What are your present living arrangements? (*)
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If other, please specify
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If you rent, what is you monthly rent?
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Please check items included in your rent, if any





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Reasons for applying to live at Northwood
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Are you working? (*)
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Occupation now or prior to retirement
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How long have you lived at your present address?
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Landlord Information
Landlord's Name
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Landlord's Address
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Landlord's Phone #
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References (other than family members)
Name (*)
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Address (*)
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Phone # (*)
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I declare this information to be correct. I understand that this application does not constitute an agreement on the part of Northwoodcare Incorporated to provide me with rental accommodations, and I further acknowledge that this application is the property of Northwoodcare Incorporated. I hereby authorize you or your agent to make any inquiries you deem necessary to verify the above statements.
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