66 Highfield Park Drive 
Dartmouth, Nova Scotia 
B3A 4X1 
Tel: 902.463-RENT / 7368 
Fax: 902.461.2213 
 

Submit your application for an apartment. fields marked with a * in bold are required. We will process your application within 2 business days. All your information is strictly to process your application and wil be kept confidential for our records.
We require a Photo ID to process your application. Please upload a photo of a Driver's license, Passport, or a photo of yourself:
* Photo ID:
Personal Information:
* First Name:
* Last Name:
* Date of Birth:
MM/DD/YYYY 		Social Insurance Number:
--
* Home Phone:
Cellular Phone:
* Current Address:
* City:
* Province / State:
* Country:
* Postal / Zip Code:
 
* Landlord's Name:
* Landlord's Phone Number:
* Type of Lease:
Month to Month Yearly 		* How Long did you live there:
yr / mo
* Why did you move:
* Email Address:
Previous Address:
Previous Address:
City:
State / Province:
Country:
Postal / Zip Code:
 
Landlord's Name:
Landlord's Phone Number:
How long did you live there:
yr / mo 		Type of Lease:
Month to Month Yearly
Did you get your deposit back:
Yes No 		If not, please explain why:
Vehicle Information:
Vehicle Make:
Vehicle Model:
Plate Number:
Province / State of Registration:
Employment Information:
* Are you currently employed: Yes No  
Employer's Name:
Work Address:
Supervisor's Name:
How Long have you been working there:
yr / mo
Position:
* Monthly Income:
$
Work Phone Number:
Ext: 		 
Details for your new apartment:
* How many people besides yourself will be living with you:

 
* What size apartment do you need:
* What date do you plan to move in:
 Click for Calendar << Click the icon for calendar
Name of 1st person living with you:
Age of the 1st person living with you:
Name of 2nd person living with you:
 Age of the 2nd person living with you:
Name of 3rd person living with you:
 Age of the 3rd person living with you:
Name of 4th person living with you:
 Age of the 4th person living with you:
Next of Kin details:
* Name:
* Relation:
* Address:
* Phone Number:
* City:
* Province / State:
* Country:
Postal / Zip Code:
How did you find us:
How did you find us:
If someone referred you, what was their name:



Submitting false information will automatically void your application, and could lead to service charges and penalties.