Sixpointe South Student Housing Application and Personal Information

Please fill out all information completely. Return application and/or lease to one of the following:

Dropbox: 805 S 3rd (Corner of Lovejoy and 3rd) dropbox in door

Mail: PO Box 4305, Pocatello, ID 83205

Email: sixpointesouth@gmail.com

Phone: 208-478-2559

Address of Property you are applying to occupy ______________________________________________

Room # Preference_________________________ Roomate Preference ___________________________

Personal Information

Name_____________________________ SSN#____________________ Date of Birth_______________

Home phone________________ Cell phone___________________ Work phone____________________

Email Address ________________________________________________

Permanent Address________________________________________Phone number________________

Present Occupation: ______________________________________________

Employer:_______________________________________________________________

Personal Reference______________________________Phone number__________________________

Vehicles List make, model, year, color, and License Plate number 1-___________________________________________________________________________________

I DECLARE THAT ALL THE FOREGOING INFORMATION IS TRUE AND CORRECT AND I AUTHORIZE THE OBTAINING OF

ANY NEEDED INFORMATION TO VERIFY. I AGREE THAT THE LANDLORD MAY TERMINATE ANY RENTAL AGREEMENT

IF THE INFORMATION IS FOUND TO INCORRECT OR UNSATISFACTORY.

Signature______________________________________________ Date _______________________