~ ECM Realty ~

870 West Fourth Street, Suite 1

Williamsport, PA 17701

Phone: 570-320-0459

E-mail: office@ecmrealty.com

"PROVIDING DISTINCTIVE and SECURE HOUSING"

"Welcome to your new Home"

 

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 * Our Offices are located on the First Floor

 

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STUDENT RENTAL APPLICATION

Please provide us with the following information.

For general questions, please visit the FAQ or feel free to CONTACT US .  Thank You!!

 

*Which Property you are Applying for?     *Apt No.:

1.  APPLICANT INFORMATION:

*First Name:    *Middle:   *Last Name:

Home Address:

      *Street:    Apt No.:

         *City:     *State:     *Zip:

         *County of Residence:     

*Phone: (xxx-xxx-xxxx)    Cellular Phone: (xxx-xxx-xxxx)

*E-mail Address:  

*Social Security No.: (xxxxxxxxx)

*Drivers License No.:      *State:

*Date of Birth:  (MMDDYYYY)        *Age:

2.  CURRENT LOCAL ADDRESS:

      Street:    Apt No.:

         City:

       Landlord Name:     Phone: (xxx-xxx-xxxx)

3.  VEHICLE INFORMATION:

Make:     Model:     Year:     Color:

License Plate No.:     State:

Vehicle Registered To: First Name:    Last Name:

*Will you be bringing your vehicle to school?

4.  SCHOOL INFORMATION:

*Dates of Enrollment:   to 

Major:

Program Length:   

Graduation Date:  

5.  PARENTS/GUARDIANS INFORMATION: (!!REQUIRED!!)

Co-Signer 1 *First Name:    *Middle Initial:   *Last Name:

Address:      *Street:    Apt No.:

                      *City:     *State:     *Zip:

                  *Phone: (xxx-xxx-xxxx)

Name of Employer:

Social *Security No.: (xxx-xx-xxxx)

         *Date of Birth:  (MMDDYYYY)

 

Co-Signer 2 First Name:    Middle Initial:   Last Name:

 Address:     Street:    Apt No.:

                      City:     State:     Zip:

                  Phone: (xxx-xxx-xxxx)

 Name of Employer:

Social Security No.: (xxx-xx-xxxx) 

         Date of Birth:  (MMDDYYYY)

 

6.  CREDIT INFORMATION:

Bank Name:

    Address:     State:     Zip:

   Checking Account? 

     Savings Account? 

*Do you have a Credit Card?

*Have you ever been evicted?

*Have you ever declared Bankruptcy?

7. *Please let us know how you heard about us.

                                        (NOTE: HOLD down the CTRL key for multiple selections)

8.  Please list any additional questions or comments you may have: (80 characters max per line)

 Line 1:

 Line 2:

 Line 3:

 

9.  Signature (Required): By typing my name below,  I (Applicant) understand ECM Realty may conduct a background check for Applicant and/or Co-Signer(s) and certifies that all information provided herein is true and correct.

 *Full Name:      *Date:  (xx/xx/xx)

Please check the form for errors and completion before submitting.

Thank You.