Apply

Applicant information

Tell us how to identify and contact you.

Full legal name *

Preferred name

Date of birth *

Phone number *

Email address *

Current address or location where you can receive mail *

City *

Province / State *

Postal / ZIP code *

Best way to contact you *

Alternate contact person (optional)

Name

Relationship

Phone

Email

May we contact this person about your application?

Yes No

Household information

How many people will live with you, including yourself? *

List household members other than yourself.

Current housing situation

What is your current housing situation? *

Renting (formal lease) Renting (informal / no written lease) Living with family or friends Temporary housing / motel Shelter or transitional housing Homeless (unsheltered, couch-surfing, or no fixed address) Other

Please describe

How long have you been in your current situation? *

Less than 3 months 3–12 months 1–3 years More than 3 years

Rent per month *

Average utilities per month *

Total housing cost per monthCalculated automatically from rent + utilities.

Do you have a written lease or rental agreement? *

Yes No

Are you at risk of losing your current housing in the next 3 months? *

Yes No Unsure

Please briefly explain

Income and employment

Other income source

Applicant monthly net income *

Partner / other adults monthly net income

Total household monthly incomeCalculated automatically from applicant + partner / other adult income.

You may be asked to provide proof of income such as pay stubs or benefit statements.

In the next three years, do you believe you can increase your income? *

Yes No Maybe

In the next three years, do you believe you can reduce your housing costs? *

Yes No Maybe

Briefly describe how you might increase income and/or reduce housing costs over the three-year period *

Program fit and goals

Three-year housing subsidy

Year 1: 50% of rent covered

Year 2: 40% of rent covered

Year 3: 30% of rent covered

By the end of the program, the goal is for your total housing costs to be about 25%–30% of your income.

Do you understand and agree to work toward this goal? *

Yes No

Coaching and advocacy support

All participants must meet regularly with a coach/advocate for support in budgeting and money management, housing stability and tenant rights, education/employment/training planning, and problem-solving and advocacy.

Are you willing to meet with a coach at least once per month (in person, phone, or video)? *

Yes No

Are you willing to follow through on an individual action plan you create with your coach? *

Yes No

What are your main goals for the next three years related to housing and finances?

Goal 1 *

Goal 2

Goal 3

What strengths or supports do you already have (skills, people, services) that can help you be successful in this program?

Support needs

Do you currently receive help from any community agencies, case managers, church, or support workers? *

Yes No

Agency / worker name

Phone / email

May we contact them to coordinate supports?

Yes No

Please check any areas where you would like support

Budgeting and managing money Finding or keeping housing Employment or job search Education or training Benefits or income support applications Mental health or wellness supports Substance use supports Conflict with landlord or neighbours Other

Other support area

Are there any barriers that might make it hard for you to attend meetings or appointments (for example, transportation, childcare, health, language)? *

Yes No

Please briefly explain

Consent and declarations

Please read carefully and check each box to show your understanding.

I confirm that the information provided in this application is true and complete to the best of my knowledge.

I understand that providing false or incomplete information may affect my eligibility for this program.

I understand that if accepted, I will receive a housing subsidy for up to three years, with the subsidy percentage decreasing each year, and I will work toward having housing costs between 25%–30% of my income by the end of the program.

I agree to participate in regular coaching and advocacy support as part of this program.

I authorize the program to contact me using the information provided in this application.

I consent to the program contacting my listed support workers or agencies to help assess my eligibility and coordinate services.

Applicant name (print) *

Date *

Electronic signature * By checking this box and typing my full legal name below, I intend to sign this application electronically.

Type your full legal name as your electronic signature *

Apply Here

Applicant Intake Form

Applicant information

Alternate contact person (optional)

Household information

Current housing situation

Income and employment

Program fit and goals

Three-year housing subsidy

Coaching and advocacy support

Support needs

Consent and declarations

Support a SAIL Family