Ukraine Housing Survey

Thank you for your interest in providing housing to support Ukrainians seeking refuge in Alberta. The purpose of this form is to collect the information needed to connect you with settlement organizations (third party service providers) that are supporting Ukrainians seeking refuge with available housing as they arrive to Alberta. As co-leads on Alberta's Ukrainian response, AAISA and CSS are only collecting information, and by submitting this form, you agree to AAISA and CSS releasing all information to third party providers. After your submission, pending AAISA and CSS receiving your Vulnerable Sector Check, a settlement organization will use the information for matching purposes. Once a housing match is arranged, they will be in touch with you directly to arrange all details. 

All AAISA and CSS volunteers and housing providers are subject to a vulnerable sector Criminal Record Check (CRC) specifically for engaging with seniors, children and vulnerable adults. For obtaining the vulnerable sector Criminal Record Check, please contact your local police service.

Please Note: At this stage, AAISA and CSS are not vetting nor reviewing the housing being offered and we do not guarantee a match will happen nor can we guarantee any time frame on the match within the available dates specified in this form, as this will depend on the volume and needs of the Ukrainians arriving.


All housing matches should be agreements with between hosts and the Ukrainians seeking refuge. In all cases, hosts and Ukrainians seeking refuge will be given the opportunity to match, with no circumstances where the either side must participate in a match. In case of any issues with the housing or the arrangement, please contact the settlement agency that initially reached out to you for initial consultation.
 
1.Are you offering housing free of charge to displaced Ukrainians?*
If Yes, please continue with the form. If No, Thank you but at this moment we are collecting information on free accommodation for Ukrainians.
2.Have you applied for your Vulnerable Sector Check for Ukrainians in Alberta?*
*This is required for each member of the household 18+ years of age. Please note, your offer will be pending the approval of your Vulnerable Sector Check. For more information on how to obtain a Vulnerable Sector Check please click here
3.Please indicate your full legal name. The name must match with the Vulnerable Sector Check application.
4.Please provide your CRC service number (if available).
5.Please indicate the full legal name of any additional persons living in the accommodation 18+ years of age. Please note the names must match with their Vulnerable Sector Check application. Please include CRC service numbers (if available).
6.Please take a clear self portrait while holding 1 piece of government ID next to your face confirming your name and address (for example AB Driver License ) & email it to housing@ukrainiansinalberta.ca  for each applicable individual over the age of 18.

I have emailed my/our self portrait(s).
7.Please specify your gender identity.  
Woman
8.Please indicate your current address of residency.
9.Please provide the best phone number to contact you.
10.Please provide your email address.
11.Please select the region where the housing offered is situated.
12.Please indicate the address of the housing you wish to provide.
13.Please indicate the duration of stay you can offer for the housing.
14.Can you offer accommodation immediately?
15.How would you describe the housing you wish to provide?
16.How many rooms are you wishing to provide?
17.Would you be willing/able to house someone who:
Yes/No
Is in need of emergency housing (who have just landed at the airport)
Is unvaccinated or who needs to quarantine?
Has potential mental health needs
Has been away from Ukraine for more than one year
Has pets
18.Are there any other factors that would be helpful to know as we try to find a family to match to your housing offer?