Ambassador Hall

*Each applicant must fill out a separate application

*There is a non-refundable fee of $45/applicant to apply.
*We do not accept cash. Make checks and money orders payable to

Lease Application

JKH Realty.

Applicant Information:
First name: _____________________________ Last Name: ___________________________ MI:_______
Permanent Address:
Street Address:_____________________________________________________________________________
City, State, Zip:_____________________________________________________________________________
Country: __________________________________________________________________________________
Identification Card (Drivers License, State ID, Passport):
Number:____________________________________ State:____________
Social Security #:______________________________
Birth Date: Month:____________ Day:_________ Year:________________
Cell Phone #: _________________________________
E-mail: ______________________________________
Dawg Tag #: __________________________________
School Name:__________________________________________________
College; Current degree/ program: _______________________________________
Year/Level: ___________________________________________________
Vehicle Information:
Make:__________________ Model:__________________ Year:____________ Color:___________________
License Plate #:___________________________________ State:____________
Emergency Contact: _________________________________________________________
Address:_________________________________________________________
Email:___________________________________________________________
Phone #:_________________________________________________________
Rental Preferences (circle one):
1. Building: Ambassador Saluki
st

Floor: 1

2. Building:
st

Floor: 1

nd

rd

rd

Single

Private

Large Private

1 Bedroom

2 Bedroom

Other: ________________________________________________________________

Ambassador
nd

Room options:

Saluki

Room options:

Single

Private

Large Private

1 Bedroom

2 Bedroom

Other: ________________________________________________________________

Preferred Move-in Date: Month: ____________ Day:_________ Year:____________

How many years/semesters do you plan to stay? __________________________
Do you plan to have a roommate (circle one):

Yes

No

If Yes:
Roommate Information:
First name:_____________________________ Last Name:___________________________ MI:_______
Cell Phone #: ___________________________________
E-mail: _________________________________________

Rental References (Current or most recent first):

Complex Name: _____________________________________________________________________
Address: ____________________________________________________________________________
Landlord name: _______________________________________________________________________
Phone #:____________________________________________________
From date: __________________________________ To Date:_________________________________
Complex Name: _____________________________________________________________________
Address: ____________________________________________________________________________
Landlord name: _______________________________________________________________________
Phone #:____________________________________________________
From date: __________________________________ To Date:_________________________________

Employer/ Source of Income:

Employer: _____________________________________________________________
Manager: ______________________________________________________________
Address: _______________________________________________________________
Phone #: ______________________________________________________________
Department: ___________________________________________________________
Date Started: _________________________________
Income: $____________________________________
Other source of income: __________________________________________________
Income: $____________________________________

Survey:
How did you come to find us?
Current resident: _________________________________________________
Website:________________________________________________________
Newspaper Ad: __________________________________________________
Flier: ___________________________________________________________
Other: __________________________________________________________

I DECLARE THAT ALL INFORMATION GIVEN IN THIS APPLICATION IS TRUE AND CORRECT. I HEREBY AUTHORIZE A
CREDIT AND/OR CRIMINAL CHECK TO BE MADE, VERIFICATION OF INFORMATION I PROVIDED AND
COMMUNICATION WITH ANY AND ALL NAMES LISTED ON THIS APPLICATION. I UNDERSTAND THAT ANY
DISCREPANCY OR LACK OF INFORMATION MAY RESULT IN THE REJECTION OF THIS APPLICATION. I UNDERSTAND
THAT THIS IS AN APPLICATION FOR A ROOM AND DOES NOT CONSTITUTE A RENTAL OR LEASE AGREEMENT IN
WHOLE OR PART. I FURTHER UNDERSTAND THAT THERE IS A NON-REFUNDABLE FEE TO COVER THE COST OF
PROCESSING MY APPLICATION AND I AM NOT ENTITLED TO A REFUND EVEN IF I DO NOT GET THE APARTMENT.

Signature: ______________________________________________ Date: ________________