Apply Online Security Deposit Required to Reserve unit = $400 ($250 refundable after move out) Security Deposit of $400 is forfeited due to a cancellation. Fill out the form below to apply online for our apartments in Wichita, Kansas. Applicant Information First Name * Middle Initial Last Name * Phone Number * Maiden Name (if applicable) Email Address * Date of Birth * Social Security Number * Number of people residing in apt. * Do you have any pets? — Yes No Breed and Weight Pet(s) Name(s) Co-Applicant Information First Name Middle Initial Last Name Phone Number Maiden Name (if applicable) Email Address Date of Birth Social Security Number Rental History Current Address Current Address * City * State * Zip * Current Landlord Reference Current Landlord Landlord Telephone Number Rental Amount How long at this address? Previous Landlord Reference #1 Previous Address City State Zip Previous Landlord Previous Landlord Telephone Number Rental Amount How long at this address? Previous Landlord Reference #2 Previous Address City State Zip Previous Landlord Previous Landlord Telephone Number Rental Amount How long at this address? Employment History Are you a full-time student? * — Yes No Present Employer Employer * Phone Number * Length of Employment * Position * Employer Address * City * State * Zip * Monthly Income (Net) * Previous/Other Employer Employer Phone Number Length of Employment Position Employer Address City State Zip Monthly Income (Net) Co-Applicant Employer Employer Phone Number Length of Employment Position Employer Address City State Zip Monthly Income (Net) Other Income Source Amount Per — Month Year Auto Information Applicant Driver’s License Number Issuing State Vehicle Make Vehicle Model Vehicle Year Vehicle Tag Number Co-Applicant Driver’s License Number Issuing State Vehicle Make Vehicle Model Vehicle Year Vehicle Tag Number Emergency Contact Information Primary Contact Name Phone Number Secondary Contact Name Phone Number Verification & Authorization * The statements above are true and correct to the best of my knowledge. Authorization is hereby given to check my credit record, to verify my credit, employment, rental and to obtain such other information deemed necessary as a prerequisite for site rental and residency. If my application is not accepted, I understand that no reason may be given. Acceptance of this application and any security deposits herewith, is not binding upon the Landlord until approved by the Landlord. If approved, all monies deposited with this application will be held as a reservation deposit to either be returned to applicant or credited toward any deposit, which may be required of application at the time a rental agreement is executed. If the applicant withdraws after the applicant is notified of approval, applicant automatically forfeits all security deposits paid. By signing, the applicant recognizes that the Landlord or his agent may investigate the information supplied by the applicant and a full disclosure of pertinent facts may be made to the Landlord. Application fee is non-refundable. Unit may be unavailable if someone has applied before you. Please call prior to submitting application to confirm availability. * Applicant Authorization Please enter the characters in the image
