Cathedral Square
  • Resident at Town Meadow
  • Resident at Holy Cross
  • chris fixing sink
  • Matter of Balance
  • fourwinds
  • group at HSH
  • JH
  • ruggles dining room
  • gazebo WHH
  • mcauley residents
  • resident with foxy lady
  • resident room at ruggles
  • GWC
  • RT gardens
  • Foliage Trip
  • Mary at TM
  • Paul and Dog
  • Nancy and Bea
  • Chiquita and daughter
  • First Home Image
  • Second Home Image
  • Whitcomb Woods
  • CSSL Winter Menu Week 1

Rental Application:

You may apply for housing from this page in one of two ways:

  1. Simply fill out and submit the electronic form below.
  2. Click here to download and print a copy of our rental application

If you have any questions about the application process, please contact us via email at info@cathedralsquare.org or by phone at (802) 863-2224.

All highlighted fields are required and also denoted with an asterisk (*).

FAMILY COMPOSITION:

Complete the following information for each person who will live in your apartment:

Name*SS Number*Birth Date*Birth Place*Sex (M/F)*Relationship

* Please include at least your email, address or phone number below:

Current Street Address*:
Street Address 2:
City*:
State*:
Zip*:
Mailing Address:
Mailing Address 2:
City:
State:
Zip:

* Please include at least one phone number:

Home Phone Number:
Cell Phone Number:
Other Phone Number:
Email Address:
How long have you lived at this address?
Do you rent?YesNo
If yes, who is your Landlord?
Landlord's Phone:
Landlord's Address:
Do you own your home?YesNo
Market Value:$
Do you live with others?YesNo
If yes, please explain your living arrangements:
PREVIOUS HOUSING:

Fill out the information for all places you have lived in the past 5 years, not including your present housing.

Landlord NameLandlord AddressPhone NumberDates you lived there
to
to
to

Have you ever lived in a property managed by Cathedral Square? YesNo
If yes, where?
Do you currently live in a subsidized or tax credit apartment (for example, do you need to provide income information each year to your landlord)? SubsidizedTax Credit
INCOME:

Please list ALL sources of income for each person who will live in your apartment. Be sure to list gross annual amounts and where the income comes from*:

EMPLOYMENT INCOME:

ApplicantsEmployer/AddressGross Weekly Salary
$
$

OTHER INCOME:

ApplicantsType of IncomeGross Monthly Amount
$
$

ASSETS:

Please list all accounts held by each person who will live in your apartment.

Bank/InstitutionType of Acct.Interest Rate %Current Balance

IRA/Keogh/Annuity/Pension/Stocks

Name of Stock# of SharesShare PriceCash ValueQtrly. Dividend
$ $ $
$ $ $

Bonds/Insurance Policies

Date of PurchaseCurrent Value/Cash Value
$
$

Do you own real estate other than the home you live in?YesNo
If yes, what is the location?
Market Value:$
Does anyone applying own any other asset not already listed?
(DO NOT INCLUDE FURNITURE AND/OR MOTOR VEHICLES USED FOR PERSONAL TRANSPORTATION)
YesNo
If yes, please describe:
Market Value:$
Have you or any member of the household disposed of, transferred or otherwise given away any cash property or other assets for less than they are worth in the past 2 years?YesNo
If yes, Description:
Cash Value:$
Amount Recieved:$
Date Disposed of:
Do you or any member of the household receive regular gifts or contributions from any person or organization? Gifts or contributions include cash, non-cash items, bills paid on your behalf, or items paid for on your behalf. Yes No
If yes, description:
Cash Value: $
Received from:
How often? (i.e. monthly):
EXPENSES:
Child Care (per month):$
Medical Expenses (per month):$
Physicians/healthcare Providers:$
Medical Premiums:$
Hospitals/Other Health Care Facilities:$
Prescription/Non-prescription Medicine:                                             $
Dental:$
Other:$
GENERAL INFORMATION:
Are you in need of a wheelchair accessible apartment?*YesNo
If offered an apartment and I accept, this apartment will serve as my primary residence?*YesNo
Are all members of the household a citizen of the United States or a non-citizen with eligible immigration status?*YesNo
Has anyone in your household ever been charged with or convicted of a crime, including but not limited to illegal manufacture or distribution of a controlled substance?*YesNo
If yes, please explain:
Is anyone in your household subject to a lifetime registration requirement under a State sex offender registration program?*YesNo
If yes, please explain:
Do you have any pets? *Note: Pets are allowed. Some restrictions apply. Ask to see our Pet Policy.YesNo
Type:
Number:
How did you hear about Cathedral Square?*
FAMILY CONTACT:

Please provide the name of any family or friends you would like involved in this application process. Please also list any family or friends we may contact if we are unable to reach you.

NameAddressPhoneRelationship

HOUSING PREFERENCES:

Please check the size of apartment and the properties that you are interested in*:
1 bedroom 2 bedroom Efficiency (Richmond Terrace & Ruggles House only)

Market Rate: No income limits.
Tax Credit: Flat-rate rent lower than market rate; income limits apply.
Subsidized: Rent is based on income; income limits apply.

* Please select at least one property:

Assisted Living 3 Cathedral Square
Burlington

Market
Subsidized
Service-enriched housing with 24-hour personal care assistance, nursing oversight, medication management, meals and housekeeping. Must be 62 or older or disabled. Medicaid accepted. Smoke-free housing
Cathedral Square Senior Living
Burlington

Subsidized Must be 62 or older or disabled. Rent is subsidized. Smoke-free housing
Heineberg Senior Housing
Burlington

Market
Tax Credit
Must be 55 or older. Smoke-free housing
McAuley Square Senior Housing
Burlington

Market
Tax Credit
Subsidized*
Must be 55 or older. *Must also apply to Burlington Housing Authority for subsidized housing. Smoke-free housing
Monroe Place
Burlington

Subsidized Service-enriched housing with preference given to individuals participating in Howard Center programs. Rent is subsidized.
Ruggles House
Burlington

Market
Tax Credit
Subsidized*
Service-enriched housing with meals and housekeeping. Must be 55 or older. Smoke-free housing *Must also apply to Burlington Housing Authority for subsidized housing.
Thayer House
Burlington

Market
Tax Credit
Must be 55 or older. Smoke-free housing
Thayer House II
Burlington

Market
Tax Credit
Subsidized*
Must be 55 or older for market and tax credit units. Must be 62 or older for subsidized units. Smoke-free housing
Holy Cross
Colchester

Market
Tax Credit
Must be 55 or older. Smoke-free housing
Town Meadow Senior Housing
Essex

Tax Credit
Subsidized
Must be 55 or older for a tax credit or 62 or older for a sub-unit. Many units are rent subsidized. Smoke-free housing
Whitcomb Terrace
Essex Jct.

Market
Tax Credit
Subsidized
Barrier-free housing for all ages. *Must also apply to Vermont State Housing Authority for subsidized housing.
Whitcomb Woods
Essex Jct.

Subsidized Must be 62 or older or 55 or older if disabled. Rent is subsidized.
Jeri-Hill
Jericho

Subsidized Must be 62 or older or disabled. Rent is subsidized.
Richmond Terrace
Richmond

Subsidized Must be 62 or older or disabled. Rent is subsidized. Smoke-free housing
Wright House
Shelburne

Subsidized Must be 62 or older or disabled. Rent is subsidized. Smoke-free housing
Grand Way Commons
S. Burlington

Tax Credit
Subsidized
Must be 55 or older for tax credit or 62 or older for a sub-unit. Many units are rent subsidized. Smoke-free housing
South Burlington Community Housing
S. Burlington

Market
Subsidized
Service-enriched housing with 24 hour personal care assistance through VNA. Must need 4 hours of personal care per day and be under age 62. Rent is subsidized. Smoke-free housing
Fourwinds
St. Albans

Subsidized Must be 62 or older or disabled. Rent is subsidized.
Whitney Hill Homestead
Williston

Market
Tax Credit
Must be 55 or older. Smoke-free housing

Section 8 vouchers are accepted at all locations that are not already subsidized.

ALL APPLICANTS MUST BE INCOME ELIGIBLE AND MEET ALL ADMISSIONS CRITERIA FOR THEIR PROSPECTIVE APARTMENT

The information regarding race, ethnicity, and sex designation solicited on this application is requested in order to assure the Federal Government, acting through the Rural Housing Service and US Department of Housing and Urban Development that the Federal laws prohibiting discrimination against tenant applications on the basis of race, color, national origin, religion, sex, familial status, age, and disability are complied with. You are not required to furnish this information, but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, the owner is required to note the race, ethnicity and sex of individual applicants on the basis of visual observation or surname:

Ethnicity:Not Hispanic or LatinoHispanic or Latino
Gender:MaleFemale
Race:American Indian/Alaska Native
Asian
White
Black or African American
Native Hawaiin or Other Pacific Island

Optional: Supplemental and Optional Contact Information for HUD-Assisted Housing Applicants

Click here to download the HUD - 92006, Supplemental and Optional Contact Information for HUD-Assisted Housing Applicants.

Instructions: You have the right by law to include as part of your application for housing, the name, address, telephone number, and other relevant information of a family member, friend, or social, health, advocacy, or other organization. This contact information is for the purpose of identifying a person or organization that may be able to help in resolving any issues that may arise during your tenancy or to assist in providing any special care or services you may require. You may update, remove, or change the information you provide on this form at any time. You are not required to provide this contact information, but if you choose to do so, please include the relevant information on this form.

Would you like to fill out this additional form?* Yes No
Applicant Name*:
Mailing Address:
Telephone No:
Cell Phone No:
Name of Additional Contact Person or Organization*:
Address:
Telephone No:
Cell Phone No:
Email Address:
Relationship to Applicant:
Reason for Contact (Check all that apply): Emergency
Unable to contact you
Termination of rental assistance
Eviction from unit
Late payment of rent
Assist with Recertification Process
Change in lease terms
Change in house rules

PLEASE READ THE FOLLOWING STATEMENT CAREFULLY BEFORE SUBMITTING THIS APPLICATION:

I/we certify that the information given on household composition, income, net family assets, allowances and deductions, as well as all other information provided is accurate and complete to the best of my/our knowledge and belief. I/we understand that false statements or information are punishable by federal law with fines up to $10,000 or imprisonment for up to 5 years. I/we understand that false statements or information are grounds for termination of housing assistance, termination of tenancy and/or retroactive rent increases.

Submitting this application constitutes my/our consent to have Cathedral Square Corporation conduct a background check, including verification of the information contained herein. I/we hereby expressly consent to the release of information by prior landlords, employers, credit bureaus/references, criminal information centers, Vermont Adult Abuse Registry, and/or the Vermont Child Protection Registry and other individuals or entities with information relevant to the information provided herein to representatives of Cathedral Square Corporation processing this application and performing the background check.

"I have read and understand this statement."