Student Leasing Application

The following application is for students only.

If you are not a student, please print/fill out and mail/drop-off the Non-Student Rental Application.

Property of Interest (if known)
Do you require any specialized accommodations made before occupying the property? Yes No
If Yes (above), please describe:

First Name	Last Name
Date of Birth	Gender Male Female
Email
Home Phone	Cell Phone
Are you a U.S. citizen? Yes No	Are you the Primary Spokesperson for your Rental Group? Yes No
What is the best way to contact you? Cell Phone Home Phone Email

For occupants to receive the same emails as you, check the box after their email address.

Closest Relative or Other Contact

Current Address (Physical)

Previous Address (if less than one year at current address)

Mailing/Permanent/Security Deposit Address

If different from Emergency Contact address

Street Address
City	State	ZIP

What School/University will you be attending during lease term?
Upcoming Year (1st, 2nd, 3rd, 4th)	Full Time Part Time
Graduate / Undergrad, Course of Study	Expected Year of Graduation
Extra Curricular Activities / Sports Involvement

Current Employer

Past Employer (If less than 6 months at current employer)

Have you ever been convicted of a felony?	Yes No
If so, state the nature of the offense, the county, state, and/or country which you were charged and/or tried, and the date of the trial and sentence given to you, if convicted:

Disclosure

Applicant hereby agrees/authorizes Veliky LC and its agents to verify: student or employment status, social security number, information regarding applicant's credit history, rental history, and criminal record which may include screening through a sex offender search and against the Office of Foreign Assets Control (OFAC) as a result of the USA Patriot Act.
Applicant authorizes verification of all references given herein, and release of information to/from Landlord or any Credit Bureau or reporting agency. Applicant authorizes Veliky LC and its agents to disclose information to future Landlords or other 3rd parties if requested in the ordinary course of business for legitimate purposes as so determined by Veliky LC and its agents. This authorization shall continue throughout the application process, the rental term, and after any termination or default of the rental agreement.
Applicant hereby declares that he/she is of legal age and that the statements above are true and understands that any rental agreement made on the basis of the information may be terminated at any time at the landlord's option if this information is found to be false.
Deposits made are non-refundable and will be applied to security deposit only. If there is no lease, the deposit is forfeited.
A Security deposit, equal to one month's rent, will be required at the signing of a lease. The first months rent to be paid before occupancy. Security deposit will not be applied for any rental payments.

Checking this box signifies that you agree to the terms and conditions contained in this application:

I Agree

NON-STUDENT RENTAL APPLICATION > SAMPLE LEASE >