McLeod Lake Indian Band HOUSING DEPARTMENT Application to Rent Schedule II A. Applicant Information (Please Print Clearly): Last Name Last Name
First or Given Name
Middle Initial
First Name
Middle Initial
B. Address: Apt # City
Street Name
Street, Road, Direction, etc
Province
Postal Code
C. Mailing Address if different from above: Mailing Address City
Province
Postal Code
D. Contact Information: Home Phone E-‐Mail Address
Mobile #
Alternate i.e. message #
E. Household Information: Last Name
First Name
Date of Birth (dd/mm/yyyy)
Age
M or F
Relationship to Applicant
Member of MLIB (Y/N)