The WINIFRED STUART MANKOWSKI HOMES consist of separate bungalow-apartments, each complete with a kitchen, where the residents can prepare their own meals. They will also do their own housework except for a periodic general cleaning service. No central dining room or nursing facility is provided. There is, in the Administration Building a library and a social-lounge room for the enjoyment of the residents. In addition, a laundry room with washers and dryers is also available.

Are these living arraignments acceptable to you? Yes No

I thoroughly understand the questions and answers in this application and if accepted as a resident will, as a working Christian Scientist do everything possible to support the purpose and aims of the WINIFRED STUART MANKOWSKI HOMES in the promotion of an enlightened sense of advancing years for the other residents as well as for myself. I also understand that if accepted for tenancy, it will be on a monthly rental basis to continue as long as I demonstrate the capacity to live independently and harmoniously support the rules of the Homes, the terms of the MANKOWSKI TRUST, and the general good of all who reside in the Homes.

I hereby grant permission to the WINIFRED STUART MANKOWSKI FOUNDATION and its agents to contact the references and to verify such information as is deemed necessary to process this application. I further attest to the fact that all I have stated in this application is correct to the best of my knowledge and belief.