* Mandatory Fields
Note: EACH resident MUST submit an application (one per roommate)

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 are the name(s) of your pet(s)?: 

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 Email Address: 

Your Information

YOUR Full Name: 

Nick Name: 

Your Email Addresses* (*Your School and a Personal Address): 

Your Driver's License (or State ID) Number: 

Issuing State of License or ID: 

Your Social Security Number: 

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 & Program: 

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 a criminal background report will be run as an integral part of the lease, and that the results of this report can be reason for being turned down for an apartment. In such case, I have the right to request criminal background checks from other agencies to defend my status. I understand that a criminal background report and this application are 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)

HAVE YOU EVER BEEN CONVICTED OF A MISDEMEANOR OR FELONY: If yes, where, what charge, in which state and court.
(Please Explain)

HAVE YOU EVER BEEN TO JAIL (other than in playing Monopoly): If yes, where and why.
(Please Explain)

We operate a drug-free, smoke-free environment. The lease specifically addresses smoking cigarettes, cigars, pipes, or any substance inside the apartment as well as possession or use of illegal substances both inside the apartment or on the property: 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)