Application for a Shared Co-Living Room

Application for a Shared Co-Living Room
Applicant Name*

First NameLast Name
Date of birth*

MonthDayYear
Date
Email
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you smoke?*

YesNo
Are you a Convicted Felon?*

YesNo
Have you ever been Evicted?*

YesNo
- Name
  
  First NameLast Name
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Name
  
  First NameLast Name
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Name
  
  First NameLast Name
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
  example@example.com
- Name*
  
  First NameLast Name
- Email
  example@example.com
- Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- Notes
- Employment/Income Proof
  
  Veteran Income Letter (Letter must be from VA)
  Cancelof
- Are you able to pay 1/2 rent deposit rent upfront, if application is accepted?*
  
  YesNoOther
- Are you able to pay a one-time, non-refundable, move-in/move-out/key set-up fee of $25?*
  
  YesNoOther
- What Payment Method do you plan to use?*
  
  Banking Debit CardDirect Express Card
- Will you be able to stay for at least 6 months?*
  
  YesNoOther
- Should be Empty: