Application for Clybourn Place Apartments

927 N. Renee St. Milwaukee, WI 53233 | Phone: (414) 933-7514 | Fax: 414-933-1975 | E-mail: marquetteapartments@rousemgmt.com | Website: www.rousecommunity.com

Lease Term:
Rank the following in order of preference:*
Efficiency One Bedroom Two Bedroom
Rank the following in order of preference:*
First floor Second floor Third floor Fourth floor – vaulted ceilings
Applicant Information
Name*
First Last
Phone*
Email*
Present Address*
Street Address City State / Province / Region ZIP / Postal Code Country
PERMANENT HOME ADDRESS*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
If you are a student Indicate current year at Marquette University:
Indicate the college you will be in next year at Marquette University:
Rental History
Do you give Clybourn Place Apartments permission to obtain information regarding your previous residence?*
- Yes
- No
Phone*
Personal Reference
Reference Name*
First Last
Phone*
Additional Occupants
Indicate below who will be sharing the apartment with you:
Name Age
Emergency Contact
PERSON TO NOTIFY IN CASE OF AN EMERGENCY*
First Last
Relationship*
Telephone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employment Information
Employer
Starting Date
MM slash DD slash YYYY
Address
Street Address Address Line 2 City State ZIP Code
Position Held
Monthly Income
Supervisor
First Last
Phone
Applicant Signature
Date*
MM slash DD slash YYYY
Signature*

This application is not a rental agreement, contract or a lease. All applications are subject to approval of Clybourn Place management.
The fair credit-reporting act, public law 91508, requires that we notify you that as a part of our normal procedure, a routine inquiry be made. This inquiry will provide applicable information concerning character, general reputation, personal characteristics, and mode of living. Upon written request, additional information as to the nature and scope of the report, if one is made, will be provided.

Name	Age

Madison

Applicant Information

Rental History

Personal Reference

Additional Occupants

Emergency Contact

Employment Information

Applicant Signature

Rouse