Civilian Housing Application

Fort Leavenworth Frontier Heritage Communities LLC II
Civilian Housing Application

Questions? Call (913) 682-6300
Please note that it is your responsibility to keep all contact information current. If the Resident Specialist is unable to contact you due to failure on your part to update contact information, your name will be removed from the waiting list.
Name*

First NameLast Name
Drivers License Number*
Drivers License State*
Date of Birth*

MonthDayYear
Date
Social Security Number*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Date Housing Needed*

MonthDayYear
Date
Status of Applicant*

SingleMarriedDivorcedGeo Bach
Background Info
Have you ever [check all that apply]:

Filed for bankruptcy?Been evicted from tenancy?Willfully or intentionally refused to pay rent when due?Been convicted of a crime? If yes, when?
Household Data (Proof of Dependent Status and Eligibility Required)

Upon availability of housing, a credit and background screening will be completed for each adult applicant as part of the approval process.
Will anyone else be residing in the home with you?*

YesNo
Dependents residing with civilian applicant: Please provide SSN for applicants 18+*
Additional Information
Desired Monthly Rent Range (From $1350 - $2700)

Minimum: $1350Maximum: $2700
How many pets do you have, if any?*
Pet Type/Breed (Check banned breeds on our website)*
Do you own a plug-in electric vehicle? (EV)*

YesNo
Do you or your dependents require any special accommodations? If yes, please provide management with additional information regarding your special housing needs.*

NoYes
Employment Information
Please provide your employment information.*
Emergency Contact
Please provide your emergency contact's information.*
Civilian Housing Checklist
Please read the following checklist and download it for your future reference.
By signing below, I acknowledge that I have read and understand the Before Move-In Checklist requirements. I agree to provide all required documentation and complete the listed items prior to my move-in date.*

Fort Leavenworth Frontier Heritage Communities LLC II

Civilian Housing Application

Background Info

Household Data (Proof of Dependent Status and Eligibility Required)

Additional Information

Employment Information

Emergency Contact

Civilian Housing Checklist