UNIVERSITY TOWERS APARTMENT APPLICATION

PLEASE PRINT

Date: ___________________ Social Security Number:_______/_______/_______

Date of Birth: ______/________/__________

First Name: ____________________ Last Name: _____________________________

Email Address: ___________________________________________________________

Current Address: _________________________________________________________

Street Address & Apartment #

__________________________ ________ __________ _______________________

City State Zip Code Country

Current Phone Number: _________________________________________________________

Permanent Address: ______________________________________________________

Street Address & Apartment #

______________________ ______ _________ ___________________________

City State Zip Code Country

Permanent Address Phone Number: ________________________________________________

Emergency Contact: ______________________________________________________

Name Relationship to you

________________________________________________________

Telephone #

Class Standing at the time of your move in: Fresh Soph Jr Sr Grad Other __

What is your area of study? ________________________________________________

Applicant Signature: ______________________________________________________

Leasing Consultant Signature: ______________________________________________

Apartment Leased: ____________