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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):

Single Adult

Couple

Single Parent with Children

Pet(s)

Male

Female

2 Parent Family

Housemate room description

Housemate room amenities:

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 independent 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