Rental Inquiry Form

Last Name *

First Name *

Nick Name

Please share your gender pronouns

Date of Birth *

Cell Phone Number *

Email address*

Current Street Address *

City *

State *

Zip Code *

Length of occupancy *

Prior Landlord's Contact #

Current Rent (if applicable)

Permanent address *

City *

State *

Zip Code *

Country of Origin

U.S. Visa

School

Department, Major

Date of Completion

Referred By

Range of how much you wish to spend monthly

What Type of Apartment? (check all that apply) What Type of Apartment? (check all that apply) Studio One Bedroom Two Bedroom Three Bedroom

Would you prefer? (check all that apply) Would you prefer? (check all that apply) Upper Floor Lower Floor Front Rear Larger private space Larger shared space Does not matter

How important is a view? How important is a view? Very Somewhat Don't care

How important is outdoor access? How important is outdoor access? Very Somewhat Don't care

Do you have an apartment preference? Building, apartment number

Do you have a roommate(s)? Do you have a roommate(s)? Yes No

1st Roommates Name

1st Roommates Student Status

1st Roommate(s) Contact #

2nd Roommates Name

2nd Roommates Student Status

2nd Roommate(s) Contact #

Would you like us to try and pair you with a roommate? Would you like us to try and pair you with a roommate? Yes, please No, thank you