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Sixpointe South Student Housing Application and Personal Information

Please fill out all information completely. Return application and/or lease to one of the following:
Dropbox: 805 S 3rd (Corner of Lovejoy and 3rd) dropbox in door
Mail: PO Box 4305, Pocatello, ID 83205
Email: sixpointesouth@gmail.com
Phone: 208-478-2559

Address of Property you are applying to occupy ______________________________________________


Room # Preference_________________________ Roomate Preference ___________________________
Personal Information
Name_____________________________ SSN#____________________ Date of Birth_______________
Home phone________________ Cell phone___________________ Work phone____________________
Email Address ________________________________________________
Permanent Address________________________________________Phone number________________
Present Occupation: ______________________________________________
Employer:_______________________________________________________________
Personal Reference______________________________Phone number__________________________

Vehicles
List make, model, year, color, and License Plate number
1-___________________________________________________________________________________
I DECLARE THAT ALL THE FOREGOING INFORMATION IS TRUE AND CORRECT AND I AUTHORIZE THE OBTAINING OF
ANY NEEDED INFORMATION TO VERIFY. I AGREE THAT THE LANDLORD MAY TERMINATE ANY RENTAL AGREEMENT
IF THE INFORMATION IS FOUND TO INCORRECT OR UNSATISFACTORY.

Signature______________________________________________ Date _______________________

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