Lease Rose-Lo - Off-Campus House Rentals

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Lease Application Form

Please fill out all of the fields below for an online submital of your Lease Application.

APPLICATION FOR LEASE

Desired Rental Address:

Year:

Full Name:

Social Security Number and Date of Birth are both required with the Lease Signing

Current Address in Bloomington:

Length of Time There/Dates:

Current Year in School:

Cell Phone #:

Email Address

Current Landlords Name:

Landlords Phone #:

Current Monthly Rent:

Employer or Source of Income:

Phone #:

Year and Make of Car:

License Plate #:

Operators License #:

State:

Parents Names:

Permanent/Parents Address:

City:

State:

Zip:

Home Phone #:

Parents Cell Phone #:

Parents Email Address(es):

IN CASE OF EMERGENCY CONTACT

Name:

Relationship:

Address:

City:

State:

Zip:

Phone #:

Applicants Signature

Date:

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Subject: Lease Application

Notes

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* All Fields Are Required fields

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