Application for Housing Agreement

Academic Status

Student at*

Term requested*

Fall class standing*

Preferences

Please rank your preferences, 1 being your highest preference; leave blank any you would not accept*.

Please indicate which options, if any, you would like to request.

Request Roommates

I would like to request specific roommate(s).

Request Another Roommate

Applicant Information

First Name*

Middle Name

Last Name*

Permanent Address*

City*

State*

Zip/Country*

Email*

Permanent Phone*

Cell Phone

SSN or Passport Number*

Citizenship

Driver's License

State

Date of birth* (Month/Day/Year) / /

Gender*

How you learned about us*

Current Residence

Address*

City*

State*

Zip*

Rent

Community Name

Management Company

Management Phone

Background

Have you ever filed for bankruptcy?

Yes No

In the past 2 years, have you applied for an apartment but did not move in?

Yes No

Have you ever had an eviction filed or left owing money to a landlord?

Yes No

Have you ever been convicted of a felony or had adjudication withheld or deferred?

Yes No

If you answered yes to any of the above questions, please describe the circumstances:

Guarantor Information

Check here if this Guarantor is also your emergency contact.

First Name

Last Name

Relationship

Address

City

State

Zip

Phone

Applicant Source of Income

I intend to self-qualify for credit without a guarantor.

You may skip this section if you will provide a guarantor. If you will not provide a guarantor, please indicate your source of income:

Employer/Source

Annual Income

Phone

Address

City

State

Zip

Special Requests

Please describe any special requests or needs for accommodation here:

Legal Terms

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SUBMITTING THIS APPLICATION

The application fee is waived when applying online. A Housing Agreement may be offered to Applicant but space cannot be reserved until Applicant and the property Owner have mutually signed the Housing Agreement. Any misstatement or omission of fact in this application will be grounds for the application to be declined and any deposit to be forfeited.

I represent that all of the information provided above is accurate and complete. I authorize Owner and its agent to verify the above and to obtain references, credit reports and public records. I have reviewed and understand the Housing Agreement. This application is not a lease or agreement for residency; only a fully signed Housing Agreement will be binding on Owner.

*By checking this box, I confirm application for a housing agreement for at and agree to the terms above.

Your Application Has Been Submitted

Thank you for submitting your application form.

A representative will contact you soon. In the meantime, please complete a short Roommate Matching Form, which is requested of all applicants.

Roommate Matching Form

There was a problem

There was a problem submitting your application form.

A representative will contact you soon. In the meantime, please complete a short Roommate Matching Form, which is requested of all applicants.

Roommate Matching Form