Rent To Own your Own Home Quick Start Application

Name*

First

Last

Email*

Current Address

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code

Home Phone*

Cell Phone (if different than above)

How did you hear about our program?*

Are you currently employed or have a steady income? *

Yes

No

Are you self-employed?*

Yes

No

Employer/Company Name

Position/Title at current job?

How long have you worked there?

How many months or years have you been in this line of work?

Your Combined household income (including child benefits)*

Total amount of money (cash) you have access (ie: savings)*

What do you pay in rent now?

How much of a monthly payment can you afford for your own home?*

Have you ever filed for bankruptcy?*

Yes

No

If yes, did you file alone or with your spouse?

Alone

With Partner

If yes, was it discharged?

Yes

No

If yes, when?

Which type of home would you like? (use link above to see properties)*

Sage at Harbour Landing, Regina

Skyy Condos in Lakeridge, Regina

Townhouses in Chester Estates in Moose Jaw

Which is the best time to reach you?