Rental Form

Please complete the form below to begin the rental process.
All information gathered here will remain private and will not be shared with any other companies.

PERSONAL INFO  
First Name:
Last Name:
E-mail:
Phone:
Present Address: How Long? yrs.     mos.    
Permanet Home Address: How Long? yrs.     mos.    
Date of Birth: (mm/dd/yyyy)    
Car: (Make/Model year)
Drivers License Number: (if appropriate)
       
REFERENCES:      
Bank: Phone:
Personal Reference:
(other than parents)		 Phone:
Credit Reference: Phone:
Credit Reference: Phone:
       
HOW DID YOU HEAR ABOUT US? (check all that apply)    
Web site   Search Engine    Daily Illini    Friend    Tenant Union    Craigslist    Other   
Did you find this Web site user-friendly? Yes     No    
       
PARENTS / EMERGENCY CONTACT INFO    
Name(s):
Address(s):
Phone Number(s):