Rental Application

Name *

First Name

Last Name

Current Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone *

(###)

###

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Other Phone

(###)

###

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Student Status *

Full Time PSU Student

Part Time PSU Student

Not in School

Who Will Be Responsible for Paying Rent *

Must choose one

Parent

Financial Aid

Self

Parent or Permanent Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

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