Application Form

Primary Applicant Name

First Name

Last Name

Email Address

Current Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Website

http://

LLAC is not an apartment or a condo. When you buy into our cooperative living community, you become a member/owner with responsibilities. What draws you to join a cooperative artists community?

How many people will be occupying the space?

Do you have any pets? What kind? How many?

Artistic Medium

Source of Income

Amount

Secondary Applicant

Secondary Name

First Name

Last Name

Secondary Address (if different)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Secondary Applicant Phone

(###)

###

####

Secondary Applicant Artistic Medium (if any)

Secondary Applicant Income Source

Secondary Applicant Income Amount

The full Transfer Value is due at closing. How will you be financing it? Please remember to attach proof of ability to pay.

Please list three personal references (name, relationship and contact information).

Are there any considerations you or your co-applicant require?

AUTHORIZATION