Management Services Corporation - Student Lease Application

Personal Information

Name		Date of Birth / /
Email		Social Security Number - -
Phone - -		Pets Yes No
Housing Desired (i.e. 'Preston Square 3BR')		How Many
When Needed		Type
Are you a U.S. Citizen? Yes No	If not, MSC also requires you to fill out the Non-U.S. Citizen Info. Sheet

Other Occupants
(Separate applications required for non-dependent occupants over 18)

Name:	Age:	Relationship:
Name:	Age:	Relationship:
Name:	Age:	Relationship:
Name:	Age:	Relationship:
Name:	Age:	Relationship:

Residence(s)

Present Address

How Long

Rent
Own

Monthly Payment

Landlord/Mortgagor Reference

Previous Address (if applicable)

How Long

Rent
Own

Monthly Payment

Landlord/Mortgagor Reference

Student Information

Educational Institution

Student ID Number

Upcoming Year

1st

2nd

3rd

4th

Grad

Emergency Contact

Contact

Relationship

Phone

Address

Criminal History

State whether you have ever been charged with, pleaded guilty to, or been convicted of, any crime other than traffic violations. If so, state the nature of the offense, the date of the offense, the county and state in which you were charged and/or tried, and the date of the trial and sentence given you, if convicted. NOTE: If you do not provide an answer to the foregoring question, then it will be resumed that your answer is 'No'.
Yes No	Charge or Conviction

Terms & Conditions

1.	Rental rates are subject to change without notice pending full lease execution.
2.	No pets of any kind are permitted on the leased premises without prior, written approval.
3.	A non-refundable, $25.00 application fee is charged to cover our expenses incurred in verifying the information furnished by you on this application. A $15.00 additional fee for criminal background processing is required for all applicants applying for The Woods community. Applicants filing this information electronically must mail applicable fees to: Management Services Corporation, c/o Marketing Department, P.O. Box 5306, Charlottesville, VA 22905. We will not be able to process this application until this fee is received. Inquiries are made to obtain information regarding applicant�s credit history, rental or mortgage history, and student or employment status. I hereby authorize the owner or his/her agent to make these inquiries and verifications.
4.	I certify that I am above legal age and the above information is true and correct to the best of my knowledge. I understand that any lease agreement made on the basis of the above information may be terminated at any time at the owner or agent�s option if this information is found to be false.
5.	The Lease Agreement was entered into based upon the representations of Tenant(s) contained in Rental Application. If any of those representations are found to be misleading, incorrect or untrue, Landlord may immediately terminate this Lease Agreement and notify Tenant(s) to vacate the premises.
6.	I hereby authorize Management Services Corporation to make oral and/or written disclosures of my Tenant records prior to, during, or subsequent to my landlord-Tenant relationship to third parties who contact Management Services Corporation seeking verification of such information in the ordinary course of business for legitimate purposes as so determined by Management Services Corporation.
7.	A copy of the criteria used to determine your eligibility to rent ('Rental Criteria') is available to you upon request.
8.	In lieu of an original signature to this agreement, landlord will accept a valid and legitimate electronic and/or facsimile signature of the resident. In so doing, resident hereby acknowledges his/her endorsement and acceptance of this agreement, and he/she waives any challenge to validity of this agreement based on residents endorsement by electronic and/or facsimile signature.

	By checking this box, you agree to the terms and conditions contained in this application.

Equal Housing Opportunity