Application

Use the form below to submit your application for our one- and two-bedroom 55+ apartments.

Steeple View Lofts 55+ Application

Step 1 of 13

Desired apartment size(Required)

PERSONAL DATA

Applicant #1 (single occupancy)

Name of Applicant(Required)

First Last

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Share residence with

Marital Status(Required)

Age(Required)

Date of Birth(Required)

Spouse's Name

First Last

Years at Current Address(Required)

Previous Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Years at Previous Address

If appointed, Power of Attorney

First Last

Power of Attorney Phone

Power of Attorney Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Power of Attorney Relationship

PERSONAL DATA

Applicant #2 (co-applicant)

Name of Applicant

First Last

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Share residence with

Age

Date of Birth

Marital Status

Spouse’s Name

First Last

Years at Current Address

Previous Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Years at Previous Address

If appointed, Power of Attorney

First Last

Power of Attorney Phone

Power of Attorney Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Power of Attorney Relationship

Emergency Contacts

Contact #1 Name

First Last

Contact #1 Relationship

Contact #1 Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact #1 Email

Contact #1 Phone (home)

Contact #1 Phone (work)

Contact #1 Phone (mobile)

Contact #2 Name

First Last

Contact #2 Relationship

Contact #2 Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact #2 Email

Contact #2 Phone (home)

Contact #2 Phone (work)

Contact #2 Phone (mobile)

Additional Information

Applicant #1

Are you employed?

Name of Employer

Position

Years of Service

Significant Volunteerism

Hobbies or Special Interests

Additional Information

Applicant #2

Are you employed?

Name of Employer

Position

Years of Service

Significant Volunteerism

Hobbies or Special Interests

Do you (either) have a current auto operating license?

Do you own an automobile?

Do you desire a parking space?

Have you (either) ever been involved in an eviction proceeding?

Have you (either) ever refused to pay rent when due?

Have you had two or more late rental payments in the last year?

Do you know of anything which may interrupt ability to pay rent?

Monthly cost for your current residency

Pets

Approved pets: dogs, cats, birds, fish. Reptiles are not permitted. Additional limitations provided upon request.

Application will be made to include a pet in my household

If yes, breed and weight

HOUSEHOLD FINANCIAL STATEMENT

Assets

Checking, Savings & Certificates of deposit

Mutual funds, Stocks & Bonds

Trust funds

Revocable annuities

Retirement fund (IRA)

Value of business

Loan to others

Other (specify)

TOTAL ASSETS

Applicant’s Monthly Income

Social Security Pensions

Annuities

Dividends & interest

Rental income

Other (specify)

TOTAL MONTHLY INCOME

Liabilities

Credit card debt

Notes payable

Other (specify)

TOTAL LIABILITIES

Personal Reference #1

May not be a relative.

Name(Required)

First Last

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Personal Reference #2

May not be a relative.

Name(Required)

First Last

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Personal Reference #3

May not be a relative.

Name(Required)

First Last

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

About Steeple View Lofts

Optional

How did you hear about Steeple View Lofts?

Motivation for moving to Steeple View Lofts?

I certify the above information to be true and correct and authorize Quality Living Choices (an entity of Landis Communities and Lessor of Steeple View Lofts) to research any above information for verification and to request a copy of my credit report. I understand that Quality Living Choices may request proof of financial status. I too understand there will be a criminal background check. I understand that this application is not binding on Quality Living Choices or me. It simply expresses my interest in becoming a resident and all information is held in strict confidence.

Applicant #1: Type your full name as an electronic signature.

Co-Applicant: Type your full name as an electronic signature.

Name of person completing this application, if other than applicant

First Last