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Application Form

    Resident Application Form

    Which building are you applying for?

    What Size of unit are you interested in?

    Do you require a tub or walk-in shower?

    Name(s)

    Address

    City

    Province

    Postal Code

    Telephone Number

    How many people will occupy your unit?

    Will you require parking?

    Are you prepared to move in as soon as a unit becomes available?

    If no, when would you be prepared to move?

    I/we understand that submission of this form does not obligate Winnipeg Mennonite Seniors Care Inc. to offer me/us a lease. I/we understand that Winnipeg Mennonite Seniors Care Inc. reserves the right to request additional information and conduct a health assessment prior to offering me/us a lease. I/we declare that I/we are at least 55 years of age.

    Agree

    Email Address