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Application Form

Please take a moment to fill out the form to apply to stay in one of our units.

Property Address

Unit #

Lease Start Date

Lease End Date

Applicant's Full Name

Date of Birth

Email

Phone #

Roommate's Name

Phone #

Current Landlord's Name

Phone #

Current Address

Driver's License #

Car Make & Model

License Plate #

Student ID #

SSN

Souce of Rental Payment (Select all that apply) * Required

Job

Financial Aid

Parent Support

Other

Other Income Sources not specified to the left

Name of School

Graduating Year

Area(s) of Study (Major)

Place of Work

Monthly Income

Emergency Contact Name

Phone #

Where did you find us?

UofM Website

Michigan Daily

Other

List others here

Have you ever refused to pay rent? If YES, explain below:

Thanks for submitting!

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