Application RGL


                        
                            RESIDENCES AT GREEN LEAF
                            1048 S. Lauderdale St.

Memphis, TN. 38126 

 

 


                        

                        2022-2023 HOUSING APPLICATION
Our studio apartments are 500 square ft, fully furnished with a kitchen, 1 bedroom, 1 bathroom, and free WIFI. 

The program requires a one-time security deposit of $250. The deposit will be returned provided no damages have occurred to the property during the tenant’s stay.
Indicate the term and year for which you are applying(Required)
								
								2022 Fall
							

								
								2023 Spring
							

								
								2023 Summer
							

								
								2023 Fall
							

								
								2024 Spring
							

								
								2024 Summer
							
Check all that apply.
Name
                            
                            
                                                    
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Address    
                    
                         
                                        
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Date of Birth
                            
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Social Security Number 
Phone
Email
                            
                        
What college or University are you attending? 
What is your area of study? 
Will you be a member of any school sponsored team or organzation? 
If you will have a vehicle on campus, please provide the Make, Model, Year, and license Plate number? 
Emergency Contact Information
Emergency Contact #1
                            
                            
                                                    
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Relationship to Applicant 
Cell Number
Work Number
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Relationship to Applicant 
Cell Number
Work Number
Medical Information
Insurance Company Name 
Group Number 
Policy Number 
Whose name is the insurance policy under?
                            
                            
                                                    
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List any medications you are allergic to and/or medical consitions that may be pertinent to the type of medical attention you receive? 
Have you ever been convicted of a felony?
I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty may render for refusal of this application or immediate termination of my housing contract. 
Signature  of Applicant 
          
            
            
            
                             
            
            
            
            
            
            
        
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