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Application For Student Housing Contract

(Must Be Completed By Applicant, there is a $25.00 non-refundable fee required )

Location of Proposed Apartment

Mosaic Student Housing At Monterey Bay
225 Cypress Ave
Marina, CA 93933

Personal Info:

Full Legal Name of Applicant

Date of Birth

Application SSN

Martial Status

SingleMarried

Address 1

Address 2

City

State

Zip code

Applicant’s Phone

Applicant's Email

Guarantor’s Info

Full Name

Address 1

Address 2

City

State

Zip

Phone

Additional Information

Reference #1

Full Name

Phone

Address 1

Address 2

City

State

Zip

Reference #2

Full Name

Phone

Address 1

Address 2

City

State

Zip

Bank Reference #1

Bank Name

Address 1

Address 2

City

State

Zip

Phone

Contact Name

Account No

Type of Account

Bank Reference #2

Bank Name

Address 1

Address 2

City

State

Zip

Phone

Contact Name

Account No

Type of Account

Student Housing Owner

Application Fee: $25

Name On Card

Card Number

Exp

CVV

I hereby certify that all the information contained above is a true and complete statement of the facts. I understand that providing false information is grounds for subsequent termination of Lease. I authorize Landlord and/lor Landlords representative to obtain confidential information regarding my credit history (including, but not limited to, obtaining an individual credit report), criminal records and/or other pertinent information from any source and/or anyone listed on this application. The undersigned waives any privacy of credit information rights or regulations.