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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. We accept credit/debit cards, money orders,

Lease Application

and checks (Make checks and money orders payable to JKH Realty)

Applicant Information:
First name: _____________________________ Last Name: _____________________________ MI: _____ Gender: _____________
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: _________________________________________________________
Email: ___________________________________________________________
Phone #:_________________________________________________________
Rental Preferences (circle one):
1. Building:
st

Floor: 1

2. Building:
st

Floor: 1

Ambassador
nd

rd

rd

Room options:

Single

Shared Bath

Private

Luxury Private

1 Bedroom

2 Bedroom

Other: ________________________________________________________________

Ambassador
nd

Saluki

Saluki

Room options:

Single

Shared Bath

Private

Luxury Private

1 Bedroom

Other: ________________________________________________________________

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


Preferred length of lease (Please specify years or semesters)? ___________________________

2 Bedroom

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: ________________