RENTAL APPLICATION

The following information on this page is required in order to process the application.
Student’s Full Name: / Student’s Cell #:
E-mail Address: / Home Phone #:
Social Security #: / State ID #:
Date of Birth: / Today’s Date:
Will you be a
Black Hawk Student? / Last Semester GPA:
Parent/Guardian Name: / Parent/Guardian Phone#:
What is the best way to contact you? /
  • Phone
  • Facebook
  • E-Mail
  • Mail
/ How did you hear about The Villas? /
  • The College
  • Flyer
  • A Villas Representative
  • Other:______

Address History
Current Address: / Parent/Guardian Address:
Current City: / Parent/Guardian City:
Current State: / Parent/Guardian State:
Current Zip: / Parent/Guardian Zip:
Source of Rental Income
Please check how you will be paying for your apartment:
  • Parents
/
  • Financial Aid
/
  • Student Loan
/
  • Scholarship
/
  • My own Income

If you will be paying for your apartment please fill out the following information:
Current Employer: / Position Title:
Employer Phone #: /
Fulltime or Part-time:
Work address: / Years Employed:
Supervisor name: / Estimated Monthly Earning: / $
Previous Employer: / Position Title:
Employer Phone #: / Fulltime or Part-time:
Work address: / Years Employed:
Supervisor name: / Estimated Monthly Earning: / $
If you will be paying for your apartment with any income, other than your own, please fill out the following:
Name of Person or Company Paying: / Account #: / Amount Paying per Semester: / $
Background
Have you been convicted or plead guilty to a crime?
If yes, please explain.
Have you been evicted? If yes, please explain.
Rental Preference (Please Check all that Apply)
  • I would like 1suitematefor the academic year.
  • I will be paying by semester.
/
  • I would like 3 suitematesforthe academic year.
  • I will be paying by academic year
/
  • I would like to be roommate matched.
  • I know whom I want to room with.
  • I will move-in at Fall Semester.
  • I will move-in at Spring Semester
  • I will move-in at Summer Semester

At Prairie Pointe Apartments, you have the option of living with 1 or 3 other students. If you know who you would like to live with, Please list below:
Name / Phone Number / Have they applied to live at
Prairie Pointe Apartments?

Page 2 of Rental Application

To complete the application process, please acknowledge the following (Initial):

  • ___I certify all of the above information is accurate
  • ___I have enclosed a $100 application fee that is non-refundable
  • ___Ihave current identification in the form of driver’s license, state ID, military ID, or passport.
  • ___I am 18 years of age or I have had a parent/guardian sign my application and will be co-signing my lease.
  • ___I authorize Management to use reasonable and necessary means to verify any of the information listed above, as well as screening my credit and criminal background, employment history and previous rental history.

I, the UNDERSIGNED APPLICANT, affirm that the information contained in this two-page application is true and correct, and I authorize Prairie Pointe Apartments, to verify all information contained in this application. Misstatements, either false or incorrect are reason for denial of occupancy. I also understand that if I rent from Prairie Pointe Apartments, and I fail to fulfill my obligations, Prairie Pointe Apartments can submit a negative credit report reflecting my rental history toa credit-reporting agency.I understand this application is the property of Prairie Pointe Apartments.

APPLICANT Signature: / Date:
Parent/Guardian Signature: / DAte:
Submit application to:
/
Prairie Pointe Apartments
/ Bus: (309) 852-0093
26228 Black Hawk Rd.
/ Fax: (309) 297-4491
Galva, IL 61434 / Email:
  • We support Fair Housing Laws and are an Equal Opportunity Employer.
  • We generally process applications in 3-5 business days, but applications can take longer if more information is required from the applicant or there is difficulty obtaining a reference for the applicant.
Incomplete and/or unsigned applications will NOT be processed

T2 Application

Prairie Pointe Apartments

9/19/2018