* Campus / Location you are applying for
* Name ( first, middle, last )
* Social Security Number ( 999-99-9999 )
I have no Social Security Number
- - ?Why do we need your SSN?
Your social security number is sent via a secure connection and used solely to verify your identity and determine credit worthiness; it will not be used for any other purposes.
* Driver's License Number
I have no Driver's License Number
* Date of Birth ( mm/dd/yyyy )
/ /
Current Information
?If you do not have a US address, please enter in a friend or family members US address or the address of the apartment you are interested in.
|
* Current Address (U.S. address only)
* City, State, Zip, Country
,
* Cell Phone ( (999) 999-9999 )
() -
JSM communicates with residents primarily via email.
Please ensure your primary email is entered here correctly
* Email
* Secondary Email
Permanent Information
?If you do not have a US address, please enter in a friend or family members US address or the address of the apartment you are interested in.
|
* Permanent Address (U.S. address only)
* City, State, Zip, Country
,
* Phone ( (999) 999-9999)
() -
Year
School
Major
|
* Emergency Name (In the U.S. Please)
* Relationship
* Address (U.S. address only)
* City, State, Zip
,
* Email
* Phone ( (999) 999-9999 )
() -
* Cell Phone ( (999) 999-9999 )
() -
If currently renting from landlord.
* Name
* Office Address (U.S. address only)
* City, State, Zip
,
* Phone ( (999) 999-9999 )
() -
* How did you hear about JSM? (check all that apply)
Former or Current JSM Resident
U of I College Pads
Sign on Building
Friends or Family
Housing Fair
Search Engines
JSM Vehicles
Other:
| Credit/Reference Check Permission |
Click here to grant JSM permission to conduct a credit check and/or previous residence reference check.
* This is required to process your application.
I hereby give JSM permission to perform a Credit/Reference Check using the information supplied on this lease information form.
|
