The information provided on this form is collected under the authority of the Personal Information Protection Act, part 2, section 3(11) and will be used to determine and verify eligibility for rental accommodation and acceptance as a Tenant.

            Submit this form or download the pdf here


Previous Housing Information:

Other Adults to Occupy Premises:

Please Note:

One Application per ADULT (18 and over), is required

I hereby certify that all statements made in this application are true and I hereby authorize Burk Management and Realty Inc. to conduct a personal investigation/credit check and to contact any person identified in this Rental Application. The failure to obtain an accurate and satisfactory credit report may, in the sole discretion of Burk Management and Realty Inc., adversely affect my application. I hereby acknowledge that there are no pets allowed on these premises without written authorization from Burk Management and Realty Inc. In order for Burk Management and Realty Inc., to comply with federal and/or provincial privacy legislation, I understand that all personal information collected from me may be collected, used and disclosed by Burk Management & Realty Inc. for the purpose of my application assessment and debt collection, to comply with applicable law. I hereby acknowledge that by checking the box below, I fully understand and agree to the terms ad conditions stated by Burk Management & Realty Inc. and give our permission to perform and adhere to the stated disclosure.

Employment Information:

Contact Info



Burk Management & Realty Inc.

‚Äč151, 10403 - 122 Street, Edmonton, Alberta T5N 4C1

Minors to Occupy Premises: