First Name:

Last Name:

Present Address:
Fill in entire address below; Street - City - State - Zip Code -

Phone Number:

Email address

PARENT/GUARDIAN INFORMATION
First & Last Name:

Phone Number:

Parent/Guardian Home Address:

Present Term (ex: junior, 2nd semester)

Cumulative Grade Point Average (GPA)

LIST OF RENTAL PAYMENT ARRANGEMENTS BELOW:
Payment schedule below: Upon signing lease, $400 Security Deposit

1st Payment (1/2 Fall rent) Due - 03/01

2nd Payment (1/2 Fall rent) Due - 06/01

3rd Payment (Spring rent) Due - 08/20

CAN YOU MAKE THESE PAYMENTS ON TIME?

YES - I can make payments on time

NO - I cannot make payments as indicated. I need a student loan/special payment schedule.

LIST OF POTENTIAL ROOMATES:
Please use the box below to list roomates:
Potential Roomates -

DO YOU KNOW ANY/ALL TENANTS IN THE APARTMENT?

YES - I know tenants

NO - I do not know tenants

If you answered yes to the above question, do you have any problems with them, or they with you?
If yes, please explain in box below;

HAVE YOU EVER BEEN EVICTED FROM AN APARTMENT OR DORMITORY?

YES

NO

If you answered yes to the above question, please explain in box below;

HAVE YOU EVER BEEN CITED FOR DAMAGING ANY HOUSING, OR DISRUPTIVE TO FELLOW TENANTS?

YES

NO

If you answered yes to the above question, please explain in box below;

PRIOR TENANCY/REFERENCES:
Year of Tenancy - Location of Apartment - Landlord's Name - Landlord's Phone Number -

How did you hear about our apartments?

To shedule an appointment to see an apartment, please give us a call:
484-201-1733 or 484-357-8476.
Select a time/day that suits all prospective tenants in your group.

I give my permission to allow any required review, contact any sources, required to make a judgement on my application. I hereby agree that all information is true and correct. I understand that falsification can result, as determined by the landlord, in immediate agreement termination.

YES - I agree to terms

NO - I do not agree to terms

If you agree with these terms, please type your signature in box below:

Please Enter Today's Date: