Apply For Residency At Valley View
Personal Information
Name:
SSN#:
Birthdate:
E-mail Address:
Cell Phone:
Home Phone:
Home Address:
City/State/ZIP:
Renting History
Previous Address:
Previous City/State/Zip:
When Did You Move Into Your Previous Address?:
When Did You Move Out Of Your Previous Address?:
Why Did Move Out Of Your Previous Address?:
Previous Landlord Name:
Previous Landlord Phone Number:
If you have never rented before,
please provide the following information:
Current or Most Recent Employer:
Current or Most Recent Employer Phone:
Please Answer Yes or No to the Following Questions:
Have You Ever Filed a Petition For Bankruptcy?
Have You Ever Been Evicted From Any Tenancy Or Had An Eviction Notice Served On You?
Have You Ever Willfully And Intentionally Refused To Pay Rent When Due?
Have You Ever Been Convicted of a Misdeamenor or a Felony Other Than a Traffic Or Parking Violation?
Are You A Current Illegal Abuser or Addict of A Controlled Substance?
Have You Ever Been Convicted Of the Illegal Manufacture or Distribution Of a Controlled Substance?
The Home Stretch
Which Type of Housing Are you Looking For?
Names of Requested Roommates:
How Did You Find Out About Valley View?
I Declare That The Foregoing Is True And Correct,
And Authorize Its Verification.
