Office 604-755-4055 | admin@valleyrentalhome.com
Online Rental Application Form
*indicates required fields.
First Name:*
Middle Name:*
Last Name:*
Date of Birth:*
Phone Number:*
Email Address:*
Present Address:*
How Long?:*
Rent/Own:*
Reason For Leaving:*
Current Landlord Name:*
Current Landlord Phone:*
Previous Address:*
How Long Did You Live There?:*
Did You Rent/Own?:*
Your Reason For Leaving:*
Previous Landlord Name:*
Previous Landlord Number:*
Employer:*
Position:*
How Long Have You Worked There?:*
Employer Address:*
Employer Phone Number:*
Salary Range:
Previous Employer:
Job Position:
How Long Did You Work There?:
Previous Employer Address:
Social Insurance Number (Optional):
Marital Status:
Drivers License #:
Professional Reference #1 Name:*
Professional Reference #1 Phone:*
Professional Reference #2 Name:*
Professional Reference #2 Phone:*
Personal Reference #1 Name:*
Personal Reference #1 Phone:*
Personal Reference #2 Name:*
Personal Reference #2 Phone:*
Emergency Contact Name:*
Emergency Contact Phone:*
Relationship to Emergency Contact:
Automobile Make:
Automobile Colour:
Automobile Year:
License Plate Number:
Full Names For All Adults (over 18) to Occupy the Premises:*
Full Names and Ages of all Minors (under 18) to Occupy the Premises:
Do You Presently Insure Your Personal Belongings & Have Third Party Liability?:*
Do You Have Any Pets?:*
If above answer is yes, please provide the type, breed and weight of each pet:
Additional Comments/Questions:
Address of Desired Rental Property:*
Have You Viewed the Property?:*
Desired Move-in Date:*

Please note : Every applicant must submit a separate application 

TENANCY WILL BE DENIED IF the applicant misrepresents any information on the application. If misrepresentations are found after the rental agreement is signed, the rental agreement will be terminated. By filling out the online tenancy application,  the applicant gives the Agent to whom the application has been submitted, permission to obtain a consumer credit report, to conduct a criminal record search, an eviction search and to make any other inquiries as deemed necessary in determining eligibility for tenancy and assessing credit worthiness. The tenant understands that the information set out in the rental application form may be used for purposes of responding to emergencies, ensuring the orderly management of the tenancy, complying with legal requirements and for collection purposes should rent be left owing or rental property damaged at termination of lease or end of tenancy.

This online form does not form a “Tenancy”, it is an offer to rent subject to the Landlords approval based oninformation supplied and other possible applicants and offers pending.

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