Rental Application

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5476 Bohlig Road, Los Angeles, CA 90032 — furnished student housing near CSULA.

Personal Information

Legal Name *

Preferred Name

Birth Date *

Gender

Place of Birth

US Citizen? *

Yes No

Other Names Used (Aliases)

Social Security Number *

Driver's License Number *

Driver's License State *

Home Phone

Cell Phone *

School Email *

Personal Email

Current Address *

Bedroom Number

Bed Space Number

Parking Type

Proposed Move-In Date *

Lease Term *

Proposed Roommates (names)

Current/most recent residence, plus up to two prior.

Current/most recent employer, plus up to two prior.

If you answered "Yes" to any question above, please explain

I authorize a consumer/credit/background report to be run as part of this application. *

Initials *

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