THE BELFAST CENTER APPLICATION

Please tell us a little about you, your business and/or need for office space. Your information will help us to provide you with The Belfast Center space that will best meet your needs.

Date:*

Date

How did you hear about rental spaces at The Belfast Center?*

First and last name:*

Home mailing address:

Street:*

Town:*

Zip:*

Phone:*

Name of your business:*

How long have you owned this business?*

If not a business, what will the rented space be used for*

Website address:*

Email address:*

example@example.com

Are you currently renting space?*

YesNo

Where:

How long have you rented this space

Amount you pay now

Why are you moving your business location:*

Does your occupation, activity or work produce noise that we should be aware of?*

YesNo

If yes, please explain:

What is your price range for an office space?*

What size office space do you want/need? Approximate square footage:*

What date do you expect to start renting office space?*

Date

Have you ever been evicted from a rental (office or housing) in the past?*

Have you ever been convicted of a crime?*

Annual income from Business:*

Other sources of income:*

Total Household Income:*

What is your credit score?*

Can you provide a fairly recent copy of your credit report?*

Are you looking for a long term office rental space?*

Please list any special office space requirements below

PREVIOUS LANDLORD REFERENCES (Provide Landlord name & phone number and length of time that you rented.

1. Name:*

Phone:*

Dates rented:*

2. Name:*

Phone:*

Dates rented:*

PERSONAL REFERENCES (Provide the names & phone numbers of two personal character references)

1.*

2.*

Once the applicant is approved, all payments are due at the signing of the lease.

Applicant Signature*

Printed Name*

Date*

Date

Apply for a space