Alliance West Real Estate Ventures, Victoria, BC

RENTAL APPLICATION FORM

Please fill out the following fields to start the application process. A representative will contact you.

If there is more then one adult please complete information for First Adult and Second Adult.
First Adult
Full Name		Telephone
Address		City
Postal Code		Date of Birth (mm,dd,yy)
E-mail		Move in Date

Current Landlord		Telephone
Employer		Telephone
Position		How long?
Current Income

Previous address		Previous Town/City
Previous Postal Code		How Long

Second Adult(if there is one)
Full Name		Telephone
Address		City
Postal Code		Date of Birth (mm,dd,yy)
E-mail		Move in Date

Current Landlord		Telephone
Employer		Telephone
Position		How long?
Current Income

Previous address		Previous Town/City
Previous Postal Code		How Long


List All Other Persons who Will Occupy the Premises
Adults
Child		Age
Child		Age
Child		Age

Pets	Yes		No
Smoker	Yes		No

Emergency Contact		Telephone
Address		Cell

Comments

Phone: (778) 440.6773
Fax: (778) 440.6773

Address: 1625 Fort Street, Box 5273,
Victoria, BC
V8R 6N4

More Information
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