You must provide all information for your application to be considered.

Check out our Terms and Conditions

Your current contact information.

Name:
Phone:
Email:

Your current Address

Address:
City:
State:
Country:
Postal/Zip Code:

Lease Information

Desired Move-in Date:
Length of Stay:
Apt. or Floor Request:
Room Type:
PrivateShared
Roommate Request:

Additional Information you wish to provide.

Identity Specific Information

SS#:
Birth Date:
Sex:
Male Female
Driver License#:

Reference 1: (Employer or Landlord)

Name:
Phone:
Relationship:

Reference 2: (Employer or Landlord)

Name:
Phone:
Relationship:
By submitting this form I do hereby authorize a Collegiate Inn Representative and consumer credit reporting agency to investigate my credit and financial history, character, general reputation, and to inquire of and check with the persons and references named herein. I further authorize such credit or consumer reporting agency to make a report in connection therewith.