Application Form
Company Name: Regency Consolidated Residential
Application To Rent: Meadow Park - 800 North Smith Road
* Fields are mandatory
Applicant Information
* First Name:
* Last Name:
Middle Name:
Contact Phone Number:
Alternative Contact Number:
Email Address:
Social Security Number (no dashes):
Date Of Birth:
Driver's License State:
Driver's License Number:
Desired Move-In Date
Applicant University Status:
Floor Plan/Number of Bedrooms Desired
Other Occupant Names
What is the total number of people in the household?
Total number of household members over the age of 18?
Applicant History
Have you ever been convicted of a felony or been required to register under a State Sex Offender Reg
Present Address Information
Present Address:
Present City:
Present State:
Present Zip:
Present Move In Date:
Present Move Out Date:
Present Reason for Moving:
Present Rent Amount:
Previous Address
Previous Address:
Previous City:
Previous State:
Previous Zip:
Previous Move In Date:
Previous Move Out Date:
Previous Reason for Moving:
Will You Have Pets?
If Yes, what breed/type? (refer to pet policies)
Present Employer
Monthly Gross Income:
Present Employer Name:
Employer Phone Number:
Present Employer Address:
When did you start with your present employer?:
Other Monthly Income Source:
Other Monthly Income Amount ($):

By typing in your legal name into the Digital Signature you are indicating that you agree with our terms and conditions and that the information you have provided is accurate. Please note that by setting up a password you are creating a new applicant account.

APPLICANT AGREES AND REPRESENTS THAT: The actual date of possession is subject to timely vacation of premises by prior resident, if any, and completion of necessary repairs or remodeling. Lessor is not liable for any damages or costs due to delays or cancellations of the assigned premises.

This application is subject to the approval of the landlord or agent. By signature below, Applicant represents and warrants all information to be true, accurate, and complete. False, inaccurate or incomplete information may result in the rejection of the application or termination of the Lease agreement. Until the time Lessor and Applicant executes a lease, Lessor shall have the right to reject this application for whatever reason.

Applicant hereby authorizes Lessor or Lessor’s agents to procure a “consumer report” as defined in the Fair Credit Reporting Act, 15 U.S.C 1681a(d), seeking information included but not limited to Applicant’s criminal background, rental history, credit worthiness, credit standing, and credit capacity. Applicant tenders herewith, in addition to any deposits, or fees which Applicant acknowledges is the cost of procuring a consumer credit report and other administrative set-up cost. The per applicant fee is non- refundable.

After the application is processed and approved the security deposit amount will be based on the property’s established Applicant Criteria. A property representative will contact you with said amount.
* Digitally signed by Applicant:
* Email:
* Password (min 7 characters):
* Confirm password:
I have read and I Agree with terms and conditions of use.