Jacobs Property Management - Rental Application

Student housing in the Kitchener-Waterloo area

Please fill out this form to apply for one of our student housing units.
* Indicates fields that are mandatory

Rental Application, dated:

First Name*:

Last Name*:

Male Female *

Date of Birth*:

Address:

City:

Postal Code:

Current Phone Number:

Email:*

Please supply one of the following:
Driver's Licence #	OR	Social Insurance #:

Are you a student?Yes No

If yes, Student ID#:

University/College Attended:

Program:

Co-op?Yes No

Applying for:
1 room	2 rooms	3 rooms	4 rooms	5 rooms	6 rooms

Names of Other Group Members (if applicable):

1.	2.	3.
4.	5.

Property Location - 511 Albert Street, (at corner of Albert Street and Quiet Place) Waterloo

Parking Required: Yes No

Lease Term - 12 months
Start Date of Lease:

May, 200

Sept.200

Start Date of Lease:

Anticipated Move-out Date

Note: The Applicant agrees that no dogs, cats or other pets or animals are allowed in the rental premises applied for without prior written permission from the Landlord.

Special Requests:

The Applicant understands that the lease for the rental premises applied for requires that every applicant have a parent or guardian to co-sign the lease, acting as a Guarantor to the lease.
Guarantor’s Full Name -
First Name:				Last Name:
Relationship to Applicant:
Address:				City:
Postal Code:				Phone #:
Email:				Employer:

The Applicant and the Guarantor hereby grant permission to the Landlord or its Agent to collect and use the information contained herein: (1) to obtain a consumer credit report; (2) to contact employers, previous landlords, references, etc.; (3) to enforce the terms and conditions of any Tenancy Agreement that may subsequently be entered into with the Applicant; and/or (4) to reasonably use it otherwise to assess this Rental Application.

Applicant's Signature:________________________

Date:_________________________

In the event that this Rental Application is completed and sent online, the Applicant understands that checking this box has the same force as a signature on a legal document. The Applicant further acknowledges that answering "Yes" in the box constitutes: (1) confirmation that the information provided by the Applicant on this Rental Application is true and accurate; (2) the Applicant’s acceptance of the terms and conditions of this Rental Application; and (3) Jacobs Property Management Inc.’s express authorization to obtain a consumer credit report, to contact employers, previous landlords, references, etc., and to enforce the terms and conditions of any Tenancy Agreement that may subsequently be entered into with the Applicant.* Yes No

How did you hear about Jacobs Property Management?
UW Housing Website	WLU Housing Website	JPM Website
Yellow Pages	Imprint Ad	Poster
Referred by:	Other:

Jacobs Property Management Inc. respects your privacy, and always keeps your personal information in the strictest confidence. The information is gathered in accordance with the Personal Information Protection and Electronic Documents Act (PIPEDA) legislation, and will be used solely for the purpose of assessing this Rental Application and determining the terms of a subsequent Tenancy Agreement should all parties agree to proceed.