Name *
Phone *
Email *
What type of accommodation do you need? * —Please choose an option—Rooming HouseIndependent UnitShare HouseApartmentTiny Home (in a local backyard)Bungalow (in a local backyard)
Is the accommodation only for you? * —Please choose an option—YesNo
How many bedrooms do you require? * —Please choose an option—Self-Contained Apartment1 Bedroom2 Bedroom3+ Bedroom
Have you already applied for housing through DHHS, Salvocare or any other agency? * —Please choose an option—YesNo
Have you been previously rejected for private rentals? * —Please choose an option—YesNo
Do you have any income other than government benefits? * —Please choose an option—YesNo
Would you be happy to talk to one of our team to discuss your needs in more detail? * —Please choose an option—YesNo
Disclaimer
By submitting the form you are accepting the Privacy Policy of Peninsula Community Housing.
Δ
Keep up to date, subscribe to our newsletter
Email Address:
