Name *

First Name

Last Name

Desired Move-In Date *

MM

DD

YYYY

Phone *

(###)

###

####

Current Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you rent or own? *

Rent

Own

Date of Birth *

MM

DD

YYYY

License Renewal Date

MM

DD

YYYY

Date of Graduation

MM

DD

YYYY

Co-Applicant #1 (Name)

First Name

Last Name

Phone

(###)

###

####

Co-Applicant #2 (Name)

First Name

Last Name

Phone

(###)

###

####

Date Worked From

MM

DD

YYYY

Salon Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Source of Income

Commission

Rental

Employees

Do you provide Brazilian Blowout or a similar service?*

Yes

No

Have you ever had an unlawful detainer (eviction notice) filed against you? *

Yes

No

Have you ever been evicted for non-payment of rent or for any other reason? *

Yes

No

Have you ever filed for bankruptcy? *

Yes

No

Have you ever been convicted of a felony? *

Yes

No

Have you ever been convicted for selling, possessing, distributing, or manufacturing illegal drugs? *

Yes

No

I HAVE READ AND AGREE TO THE TERMS AND CONDITIONS STATED ABOVE *

Check to Confirm

Today's Date *

MM

DD

YYYY