Nevada State College

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The Village Student Housing Application
All information with a gold label is required.
Applicant Information
First Last
Permanent Home Address
Street
Street2/Apt
City
State Zip
Province/Country
Date of Birth
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Have you ever been evicted?  


Have you ever been convicted of a felony?  


Have you ever filed for bankruptcy?  


Please provide 2 forms of identification.
Type 1  
ID Number:
Type 2  
ID Number:


Home Phone
Cell Phone
SSN
Gender (For Room Assignments Purposes Only):




Preferred Pronouns
E-mail Address:
Choose the e-mail address you prefer to receive information:
 
School Information
Are you a student?
Are you a First-Generation College Student?
College Attending:  
Expected Move In: 
Lease Term Choice: 
Expected Graduation Date        
Emergency Contact Information
First Last
Cell Phone
Work Phone
E-mail
Street
Street2/Apt
City
State Zip
Province/Country
Guarantor Information
All Applicants are required to provide a guarantor. A guarantor is someone who will sign a Guaranty Agreement and will also be financially responsible under the Lease Agreement. Most Applicants select a parent or guardian to be their Guarantor.

Applicants who wish to be their own Guarantor must earn an annual gross income equal to three (3) times the total rent installment and must have qualifying credit history. Applicant must have held that employment for at least one (1) year prior to the Housing Application date. Proof of income must be supplied via two (2) recent pay stubs, four (4) if paid weekly, two (2) most recent bank statements, financial aid award, I-20, tax records or court documents.
First Last
SSN
Cell Phone
Work Phone
E-mail
Street
Street2/Apt
City
State Zip
Room Preference

Please list preferred roommates (max of three):



If possible, I would like to be assigned to:


If possible, I would like to be assigned to the following unit type:

1st Choice:   
2nd Choice: 


Preferences
The following information will be used for roommate matching only.  Please complete this section as if you were talking to a prospective roommate and keep in mind that your honesty will benefit both you and your roommates.  Check all items that apply.
Smoking:
Alcohol:

On most weeknights I:
On most weekends I:
Studying:
Where I Study How Much I Study When I Study

Other people consider me to be:
Immaculately Clean [1]
Very Messy [5]
Extremely Quiet [1]
Really Outgoing [5]    
Morning Person [1]
Night Person [5]
Do you require housing accommodations due to a disability? If yes, please explain in box below. You may be required to provide documentation regarding your disability.
I give permission to release my contact information and roommate matching preferences to prospective roommates.
How did you hear about us?
Terms and Conditions

Applicant understands that acceptance of this application does not assure a room reservation. A bedroom accommodation shall be reserved only upon signing of a Lease Agreement by all parties before the applicable property reaches full capacity. This application will be approved only upon confirmation all rental requirements and qualifications have been met.

Applicant understands that if, at any time, there are vacant bedrooms in the applicant's assigned apartment, Capstone On-Campus Management reserves the right to assign roommates without prior notice and/or to relocate the applicant to another unit.  Applicant further understands that roommate compatibility is not guaranteed.

Applicant represents that all of the above information is true and complete and authorizes the verification of same by reasonable means.  Any misrepresentation or omission may be cause for the rejection of this application and/or the termination of the License Agreement. 

Applicant understands and agrees that a security deposit in the amount of $200.00 is required to reserve a space in The Village, and failure or refusal to provide this deposit may result in the cancellation of this application and any resultant Lease Agreement. Applicant agrees that the security deposit will be applied to any damage charges upon move out.

I, the Undersigned Applicant, have read and agree to all terms and conditions set forth in this application.  I understand that this application is part of my License Agreement, especially those areas regarding earnest monies.

APPLICANT SIGNATURE: 


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