On-line Application 312


All Fields Required. Please enter "none" or "NA" if question does not apply.
 
Applicant
Name (Last, First, Middle):
 Social Security No:
 Date of Birth:
Email:
 Emergency Contact:
 Phone Number:
Student:
YES/NO
  		College Attending:
 School or Department:
 
Spouse
Name (Last, First, Middle):
 Social Security No:
 Date of Birth:

 
 
Current Residence
Address (Apt, Street, City, State & Zip):
 Phone No:
How long there?
 OWN/RENT
  		Present Landlord
 Landlord Phone No:
Amt. Present Rent?
$		 Lease Exp. Date

 		  
 
Apartment Desired		  
When Desired:
  Apartment Selection:
   
 
Total Occupants
Total No. of persons who will live in unit:
List below all occupants not mentioned above.
(1) Occupant Name:
 Relationship:
 Date of Birth:
(2) Occupant Name:
 Relationship:
 Date of Birth:
(3) Occupant Name:
 Relationship:
 Date of Birth:

 
 
Work Infomation
  Applicant Spouse
Employer's Name
Employer's Address
How long Employed
Position
Supervisor's Name
Work Telephone
Annual Income $ $
 
 
Bank Information
(1) Bank Name:
 Branch:
 Type of Account:
(2) Bank Name:
 Branch:
 Type of Account:

 
 
Vehicle Information
(1) Year:
 Make:
 Model:
 Color:
 Liscense No:
(2) Year:
 Make:
 Model:
 Color:
 Liscense No:

 
 
If a student, or your major source of income is parent or guardian, please supply the following information
Parent/Guardian Name:
 Will parent/guardian guarantee rent payment? YES/NO
 
Address (Street, City, State & Zip):
 Home Phone No:
Parent/Guardian Employer:
 Work Phone No:

 
   
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