Professional / Travel Nurse Rental Application
Bonita Haven / 3622 Wild Oats Lane, Bonita, CA 91902
Requested Lease Dates From
To
1. Applicant Information
Full Legal Name
Date of Birth:
Phone Number:
Format: (000) 000-0000.
Email Address:
example@example.com
Current Address:
Emergency Contact Name & Phone:
2. Employment & Assignment Details
Staffing Agency:
Hospital / Facility Name:
Position:
Assignment Start Date
End Date:
Monthly Gross Income (Estimate):
Recruiter Name & Contact (if available):
I will provide a copy of my assignment contract / offer letter
3. Financial Information
I will provide proof of income (pay stub, contract, or bank statement)
Have you ever been unable to pay rent on time?
Yes
No
If yes, please explain:
4. Rental History
Previous Landlord / Housing Reference:
Name:
Phone/Email:
Have you ever been evicted?
Yes
No
5. Background & Screening Authorization
I consent to a background and credit check
6. Occupancy Details
Number of Occupants
Will you have pets?
Yes
No
If yes, type/breed/weight:
Vehicle Information (Make/Model):
7. Acknowledgments
I understand this is a furnished rental
I agree to abide by house rules and lease terms
I understand utilities (circle one): Included / Not Included
Included
Not Included
I understand a security deposit is required
8. Signature
I certify that the information provided is true and complete.
Signature
Date:
-
Month
-
Day
Year
Date
Landlord Use Only
Application Received:
Screening Completed:
Approved Denied
Approved
Denied
Notes:
Heading
Heading
Submit
Should be Empty: