Name______________________________ Current Address________________________________
_________________________________________________________________________________
Phone Number: ______________________________ Cell Phone Number: ____________________
Your E-Mail Address________________________________________________________________
Parents’ Name _____________________________ Parents’ Phone Number____________________
Parents’ Address ___________________________________________________________________
Will your parents sign a Parental Guarantee (to ensure payments and lease enforcement)? _________
We have a no pet policy. Is this agreeable to you? _______________
We have a no illegal drugs and no underage drinking policy. Is this agreeable to you? ____________
We have a no smoking in the building policy. Is this agreeable to you? ________________________
Previous Landlord/Dormitory Name:______________________ Phone #: ______________________
Preferred Rental Start Date: _____________________________ End Date: ____________________
Please record your planned School Session: Day _____________ or Night ____________________
Do you know other students who want to lease an Apartment with you? ________. If so, please list their names and phone numbers:___________________________________________________________, ______________________________________, __________________________________________.
The undersigned hereby attests that the above information is true.
Signature ________________________________ Date _____________________________________
Please complete and the send, fax or email this Rental Application to:
Robin Ostach, 162 Meadow Drive, Beaver Falls, PA, 15010.
Cell Phone 724-462-5230
Home Phone and fax number 724-384-0275 (call before faxing).
Costach@comcast.net
Below is for Owners Use Only………………………………………………………………………...
Date received _________________________ Date of interview _________________________
Comments ________________________________________________________________________
_________________________________________________________________________________.
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