Housing Request

Name: Full Name: *
Phone: Phone: *
Email: Email: *
Current Address: Current Address: *
Move-In Date:Move-In Date:
Preferred City Area:Preferred City Area:
Type of Accommodation:Type of Accommodation:	Apartment Condo House Loft Room Townhouse
Furnished:Furnished	Yes No
Number of Tenants:Number of Tenants:	1 2 3 4 5 6 7 8 9 More than 9
Number of Bedrooms:Number of Bedrooms:	1 2 3 4 5 6 7 8 9 More than 9
Rental Period:Rental Period:	Short Term 1 Year More than 1 year
If Short Term, How Long?If Short Term, How Long?
Do You Have Pets?Do You Have Pets?	Yes No
If Yes, please specify:If Yes, please specify:
Smoker:Smoker:	Yes No
Maximum Budget:Maximum Budget:
Employment:Employment:	Yes No
Referred By or Salesperson Referred By or Salesperson: *
Additional Comments:Additional Comments: *
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