Application

Please complete all requested information of this form. Thank you for your interest.

Apartments are offered for rent without regard to race, color, religion, sex, national origin, disability, or familial status.

Applicants Checklist

A completed application requires the following be submitted with the completed application

  1. Payment of $25 application fee (payable to Alder Springs Deaf & Blind Community)
  2. Criminal background report
  3. Independent Living Declaration (printable document)
  4. Applicants General Authorization Statement (printable document)

Resident Application for Alder Springs

Full names and dates of birth for additional residents. ex. John Doe - 03/22/1980, Jane Doe - 02/25/1983
Please list kind of pet, breed, weight, and age for each pet

Present Residence

000-000-0000
000-000-0000
000-000-0000

Previous Residence

mm/year - mm/year
000-000-0000

Present Employment

mm/year - present
000-000-0000

Previous Employment

mm/year
mm/year
000-000-0000

Co-Applicant Employment

mm/year - present
000-000-0000
Including company vehicles

Vehicle 1

Tag Number and State

Vehicle 2

Tag Number and State

Additional Vehicles

Information on any additional vehicles (Car, Motorcycle, etc.)

List all means of regular income you want considered below.

Income 1

Work, Investment, etc
000-000-0000

Income 2

Work, Investment, etc
000-000-0000

Income 3

Work, Investment, etc

Additional Income Information

Applicant is not required to reveal alimony, child support, or spouse/partner annual income unless applicant wants it considered
Including expected changes to monthly income

Has the Applicant or Co-Applicant ever (check if yes):

000-000-0000
000-000-0000

I hereby make application for an apartment and certify that this information is correct. I authorize you to contact any listed references. I also authorize you to obtain my consumer credit report from a credit reporting agency and my criminal background report. I understand that these reports will appear as inquiries in my file.

A $25 application fee will be charged to your card.