Information Form Name Middle Name Last Name Birthday Phone Number Email Address Occupation How did you find out about us? Refferer Agency(if any) Expected move-in date Expected move-out date What kind of accommodations are you interested in? Shared RoomPrivate RoomStudio 1 Bedroom2 Bedroom3 Bedroom Gender FemaleMaleOther Do you smoke? YesNo Have you ever been convicted of a felony or gross misdemeanor? YesNo Notes Please indicate if you have any notes, preferable city or neighborhood/s Reference code (If you have any) I affirm that I have read and understand, and accept the terms and conditions.