Seniors Housing Application

You will note on the application we look after a number of independent seniors housing units in our area, and this application covers all of these.  You may indicate your preference, if you have one, on this form. We emphasize that you answer all questions, as we do a “point scoring” on each application – it is not a case of  “first come, first served.”  Have your doctor(s) complete the medical form and return it directly to us.

We are government-subsidized housing for low to mid-income families and seniors, for the Lloydminster (Alberta side only), Kitscoty and Marwayne areas.  The following information pertains to the Seniors housing only.  Rental cost is currently legislated to be no more than 30% of the gross income of the household, with the maximums set right now between $600 or $700 for the seniors accommodations, depending upon which complex you are living in.  In addition, there is a recovery cost for electricity of $50 per month, and a parking charge of $10 per month.  There are (3) complexes in which the user pays their own electricity bills directly (Fellowship Village, Alberta Rose Manor, and David Thompson Manor).  The heating and water/sewer is paid by Lloyd Region Housing.  We also provide a fridge and stove in each suite.  The laundry facilities are free-of-charge, and shared between tenants.

In the complexes which have more than one floor there is elevators, and bars are installed in all the bathrooms.  All suites are one-bedroom only.  There is no health services provided from our agency.  In addition, we need your doctor to sign off on the medical form(s) for each of you, stating you are functionally independent.   There is a minimum age restriction of 65 for our seniors facilities.  In the case of a married couple, at least one of you must be age 65 or older.

We have strict ‘No Pets’ and ‘No Smoking’ policies.

DUE TO THE CURRENT RESTRICTIONS ON VISITORS & SOCIAL DISTANCING, WE ARE UNABLE TO SHOW YOU A VACANT SUITE AT THIS TIME.  YOU WILL BE SHOWN THE SUITE JUST PRIOR TO SIGNING THE LEASE.

Sincerely,

Lloydminster Region Housing Group

Deanna Stang-Livingston – CAO / Site Manager
Padua Place, Southridge Estates
Knox Manor, Fellowship Village

Sharon Kneen – Site Manager / Maintenance
David Thompson Manor, Marwayne Valley  Manor
Alberta Rose Manor

N.B.  If you are interested in living on the Saskatchewan side of Lloydminster, you will need to contact the Lloydminster Housing Authority @ 306-825-5376 as they operate as a completely separate entity.

DISCLAIMER FOR FORMS CONTAINING PERSONAL INFORMATION ON MANAGEMENT BODY TENANTS

Information on this form is being collected under the Authority of Ministerial Order

No. H:032/99 issued under the Alberta Housing Act (RSA 1994/A-30.1).

It will be used to enable staff of the LLOYDMINSTER REGION HOUSING GROUP to provide support services to tenants residing in Housing Units operated by the LLOYDMINSTER REGION HOUSING GROUP.  It is protected from public disclosure by the provisions of the Freedom of Information And Protection of Privacy Act (RSA 1995/F-18.5).  If you have any questions about the collection of this personal information, please call (780)875-9131 between the hours of 8:30 a.m. and 4:30 p.m. Monday through Friday for clarification.

    Application for Accommodation - Senior Citizen (Confidential)

    PLEASE READ CAREFULLY AND ANSWER ALL QUESTIONS COMPLETELY.

    I understand that this application does not constitute an agreement on the part of the Lloydminster Region Housing Group or it's agents to provide me with rental accommodation.

    I further acknowledge the right of the Lloydminster Region Housing Group or it's agents, at any time prior to the execution and delivery to me of a lease hereby applied for, to withdraw, revoke or cancel, without any penalty or liability for damages or otherwise, any acceptance or approval of this application previously made or given.

    I hereby authorize the Lloydminster Region Housing Group or it's agents to investigate any or all of the statements made herein, being fully aware that discovery of any false statement shall cancel any further consideration of my application.

    I further agree that I am obligated to advise the Lloydminster Region Housing Group or its agents, in writing, of any changes in family composition, gross family income, assets, employment, or change of address, should they occur.

    I ALSO AGREE THAT THE INFORMATION PROVIDED BY ME PERTAINS TO ALL PERSONS NAMED WITHIN THIS APPLICATION.

    I/we do solemnly declare as follows:

    1. That I/we am/are the applicants named in the said application.
    2. That the statements made by me/us in the said application are, to the best of my/our knowledge, information and belief, full and true in all respects.

    Canadian CitizenLanded ImmigrantOther
    OwnRent
    HouseApartmentRooming HouseMotel/HotelCondoOther
    KitchenBathroomBedroom
    YesNo
    YesNo