Form Builder - City of Burlington

Required fields are marked with asterisks (*)

Better Homes Burlington

Purpose

Application for interest in Better Homes Burlington pilot program.

Additional Information

After filling out this application form, applicants will be contacted by the Better Homes Burlington Coordinator to collect additional information in a Funding Request Form. Applicants are advised to consult the Better Homes Burlington team to confirm submission requirements after filling out this application form. Email: betterhomes@burlington.ca

Notice of Collection

Personal Information contained on this form is collected under the authority of the Municipal Act, 2006, S.O. 2006, Chapter 11, Schedule A, s. 136 (c), Ontario Regulation 596/06, s.35 under this Act, and the City of Burlington By-law: 40-2023. Information collected is used for the administration and management of the Better Homes Burlington Pilot Loan Program. Questions about this collection can be directed to the Program Coordinator, Better Homes Burlington - Loan Program, 426 Brant Street, PO Box 5013, Burlington, Ontario, L7R 3Z6 or betterhomes@burlington.ca or by telephone at 905-335-7600 x 7974

Property Information

Address (Number, Street, Suite #):

City:

Province:

Postal Code:

Select building type

detached home

semi-detached home

townhome

Select heating type:

natural gas

oil

electricity

Property Owner Information

First Name:

Last Name:

Mailing Address (Number, Street, Suite #):

City:

Province:

Postal Code:

Contact phone number:

Owner Email address:

Is the property owner the applicant?

Yes- I am the property owner.

No- I do not own the property. I am applying on behalf of the owner.