Student Application

Student Application
Housing Term Needed
Name *

First Name Last Name
Date of Birth *

Month Day Year
Date
Social Security # *
Drivers License #
State of Issue
Cell Phone Number
Please enter a valid phone number.
Email Address *
example@example.com
Can we send information from B.C. Parker Real Estate to this email address?

Yes No
Current Class Ranking

Sophomore Junior Senior
Anticipated Graduation Date

Month Day Year
Date
Do you plan on studying abroad?

Yes No
When do you plan on studying abroad?
Do you plan to have someone take your room while abroad?

Yes No
Please provide their name
Property Applying For/ Property Interested In (Please list 3 different properties):
First Choice
Second Choice
Third Choice
Future Roommates Names
GUARANTOR INFORMATION:

In most cases, your lease must be guaranteed by one of your parents or your guardian. Please provide the information below. This person will receive further paperwork via email using the information you provide below.
Guarantor Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Please verify that you are human *
Should be Empty:

GUARANTOR INFORMATION: