Housing for Healthcare Form - Waypoint Centre

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Housing for Healthcare Form

Home Get Involved Join Our Team Housing for Healthcare Housing for Healthcare Form

Personal Information

Name(Required)

First Last

Email(Required)

Phone(Required)

Accommodation Information

Rental Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Type of Housing(Required)

Full House

Condo Unit

Apartment

Room in House - Above Ground

Room in House - Basement

Other

Number of bedrooms?(Required)

Fully furnished?(Required)

Yes

No

Rent amount per month?(Required)

Is first and last month required?(Required)

Yes

No

Are all utilities included in rent?(Required)

Yes

No

If no, please list utilities NOT included(Required)

Laundry onsite?(Required)

Yes

No

Free parking available?(Required)

Yes

No

Pet Friendly?

Yes

No

If yes, which pets are allowed?(Required)

Dates available?(Required)

Winter Months

Long Term

Short Term

Other

If short term only, how long is your accommodation available?(Required)

If other, please state available dates:(Required)

Is your accommodation fully maintained? (i.e. snow removal, grass cutting)(Required)

Yes

No

If yes, what is included in the maintenance of the property?(Required)

Do you consent to share the data collected in this form with Waypoint employees and potential employees who are looking for housing opportunities?(Required)

Yes

Waypoint Centre for Mental Health Care
500 Church Street Penetanguishene, ON L9M 1G3

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