* Mandatory Fields
Note: ALL residents MUST submit an application (roommates included)

Who referred you? 

Applying for One or Two Bedroom Apartment:  1 2

Apartment Location Preferred:  Hampton Little Savannah Pincushion Lane (Bldg. 1) Pincushion Lane (Bldg. 2) Bulldog Acres Hampton Uptown Hampton Overlook Pincushion Overlook First Available Dog Friendly
     Comments:
     

Moving-In Date Preference: 
     Comments:
     

Your Pet

What is the name of your pet?: 

Breed (put N/A if no pets): 

Size (height): 

Weight (lbs): 

Veterinarian: 

Vet Address and City: 

Your Roommate

Name of Roommate: 

Roommate's Phone: 

Roommate's Email Address: 

Your Information

Full Name: 

Nick Name: 

Your Email Address: 

Date of Birth*:  January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Car Tag:       State Car is Registered: 

Cell Phone Local Phone

Home Address*: 

     City/State/Zip: 

Current Address*: 

     City/State/Zip : 

Current Landlord*: 

     Landlord Address*: 

     City/State/Zip: 

     Phone Number: 

When does you lease expire?: 

Your Work and/or Study Program

Are You a Student:  Yes No    Where: 

Anticipated Graduation Date: 

Where Do You Work?*: 

Telephone Number*: 

Address*: 

Supervisor's Name*: 

Phone Number*: 

Supervisor's Email

Family or Emergency Contact

Parent or Guarantor Name (#1)*: 

   Parent Address 1*:         

   City/State/Zip    

   Home Phone*:         

   Cell Phone :         

   Email Address :         

Parent or Guarantor Name (#2)*

   Address*:         

   City/State/Zip:     

   Home Phone*:         

   Cell Phone:         

   Email Address:         

Your References

Reference #1 (Employer/Faculty Member)*: 

   Work Phone*:         

   Home Phone        

   Years Known        

Reference #2 (Employer/Faculty Member)*: 

   Work Phone*:         

   Home Phone:         

   Years Known:         

I understand that this application is an integral part of the lease. Application fee of $35 is used for credit reporting and will be withheld from any refund of deposit.
(Type your full name here to agree)

We operate a drug-free, smoke-free environment. The lease specifically addresses smoking inside and illegal substances: Neither is permitted. Any indication of illegal substance use in or around an apartment or on our properties will result in reporting to the authorities, immediate eviction, and lease becoming due and payable in its entirety.
(Type your full name here to agree)

Security Deposit ($500 for one bedroom, $750 for two bedroom apartment) and first month's rent must be paid before moving in. Spot reservation will be held only after initial security deposit is received.
(Type your full name here to agree)

I agree that all the information on this application is true and correct to the best of my knowledge.
(Type your full name here to agree)