First Name
(Required)
Last Name
(Required)
Email
(Required)
Phone
(Required)
Number of all members in your household over 19
(Required)
Number of all members in your household under 19
Source of Income
(Required)
OAS/GIS and CPP or Private Pension
Employed or Self Employed
Income Assistance
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What is your total gross household income per month?
(Required)
Are you applying for subsidized housing?
(Required)
Yes
No
Please provide your BC Housing file number
(Required)
Do you identify as First Nations?
Yes
No
Preference is being given to First Nation applicants, in particular to members of Songhees and Esquimalt Nations on whose unceded lands we are situated.
Tell us a bit about yourself and your housing needs. If you're interested in a particular Cool Aid property, please let us know.
(Required)
Residency
(Required)
Canadian Citizen
Permanent Resident
Other
What is your preferred building?
Crosstown
210 Gorge
Mount Edwards
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