Student Rental Application

Ivy Square Realty & Mgt. Co., 2125 Ivy Road – Suite C, Charlottesville, VA 22903

Ph#: 434-296-9128 Fax#: 434-296-6108 Email: ivysquare@embarqmail.com

www.ivysquare.com

Apartment Address: _________________________ * Applicants must be 18 yrs or older

Tenant 1

Name		Mother’s Name
Local Phone		Father’s Name
Cell Phone		Parent(s) Ph#
Present Address		Parent(s) Address
Birth Date		Name of School
SS#		Graduate Year
Emergency Contact		Emergency Contact Ph#
E-mail Address		Employer & Ph#
Driver’s License#
How did you hear about this apartment?
How long do you think you would be renting from us?

*By signing the application you grant us permission to communicate with all the contacts listed in this section in the event we can’t locate you.

Tenant 2

Name		Mother’s Name
Local Phone		Father’s Name
Cell Phone		Parent(s) Ph#
Present Address		Parent(s) Address
Birth Date		Name of School
SS#		Graduate Year
Emergency Contact		Emergency Contact Ph#
E-mail Address		Employer & Ph#
How did you hear about this apartment?
How long do you think you would be renting from us?

*By signing the application you grant us permission to communicate with all the contacts listed in this section in the event we can’t locate you.

Tenant 3

Name		Mother’s Name
Local Phone		Father’s Name
Cell Phone		Parent(s) Ph#
Present Address		Parent(s) Address
Birth Date		Name of School
SS#		Graduate Year
Emergency Contact		Emergency Contact Ph#
E-mail Address		Employer & Ph#
How did you hear about this apartment?
How long do you think you would be renting from us?

*By signing the application you grant us permission to communicate with all the contacts listed in this section in the event we can’t locate you.

Tenant 4

Name		Mother’s Name
Local Phone		Father’s Name
Cell Phone		Parent(s) Ph#
Present Address		Parent(s) Address
Birth Date		Name of School
SS#		Graduate Year
Emergency Contact		Emergency Contact Ph#
E-mail Address		Employer & Ph#
How did you hear about this apartment?
How long do you think you would be renting from us?

*By signing the application you grant us permission to communicate with all the contacts listed in this section in the event we can’t locate you.

Our Policy

The security deposit, first month’s rent, and signature of all adults who appear on the rental agreement are necessary before keys can be released on your move-in date. Workman must have access to your apartment; we are not able to allow personal belongings to be placed in the apartment before the move-in date.

It is the policy of this organization to keep all personal information confidential. Your email address is vital in communicating with you in regards to your residency. No Junk mail will be sent.

I hereby certify that I am of legal age, and that all the above information is true and correct to the best of my knowledge and that any rental agreement made on the strength of material information may be terminated at any time at owner/management’s option if it is found to be false. I understand that verification of references given and a credit check may be obtained. This application, if approved, becomes part of the rental agreement. In addition, I have read and understand the rules and regulations of the apartment community, which are also a part of the rental agreement. I agree to abide by them if accepted as a resident.