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HOUSEHOLDER APPLICATION

This is a Task Exchange application to be completed by HomeShare Consultant or designated representative.

Please note: Form must be completed in one session and can not be saved as a draft.

TASK EXCHANGE HOMESHARE

APPLICATION

Householder Information

Homeshare Consultant

Homeshare Assessment Visit

Householder/or Representative Contact

Householder Contact

Personal Information

Marital status

Do you have any pets? *

Yes

Gender

Do you live by yourself?

Do you smoke (tobacco or cannabis)? *

Yes

Choose HOUSEHOLD tasks you would like help with:

Meals

House cleaning

Laundry

Changing linens

Grocery Shopping

Organize/Decluttering

Choose OUTDOOR tasks you would like help wih:

Lawncare

Gardening

Driveway snow clearing

Walkway snow clearing

Recycling/Trash

Choose SPECIAL tasks you would like help with:

Computer & Tech support

Pet care

Home repairs

Home maintenance

Transportation

Please provide two personal references who you have known for at least 2 years

Please select preferred Housemate Occupants (all that apply): * Required

Single Adult

Couple

Single Parent with Children

Pet(s)

Male

Female

2 Parent Family

Housemate room description

Housemate room amenities: * Required

Furnished Bedroom

Unfurnished Bedroom

Ensuite Bath

Private Bath

Shared Bath

Basement Bedroom

Valid government issued photo identification required

I will be able to provide a copy of the most recent municipality property tax bill or copy of lease: *

Yes

Location/Neighbourhood Detail:

Householder Detail:

Homeshare Detail:

Property Detail:

I certify that my answers are true and complete to the best of my knowledge. If this application leads to a HomeShare opportunity, I understand that false or misleading information in my application or interview may result in the termination of the homeshare program.

Remember to submit the following to complete the application:

1. Government issued photo ID
2. Proof of residence
3. Reference checks

Quality matches. Insightful process. Meaningful results.

Award-winning social enterprise providing a reliable and systematic approach that leads to happy and lasting homeshare matches.

We have a network of professionally trained homeshare consultants ready to serve householders residing in Halton and Hamilton-Wentworth regions in Ontario Canada

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HOUSEHOLDER APPLICATION

TASK EXCHANGE HOMESHARE

​APPLICATION

Remember to submit the following to complete the application:

1. Government issued photo ID 2. Proof of residence 3. Reference checks

APPLICATION

1. Government issued photo ID
2. Proof of residence
3. Reference checks