The Regency

Application for Housing

The Regency: Auraria's Student Housing Community, LLC

Please submit your application with a $100 non-refundable Application/Service Fee and a $50 Security Deposit made out to The Regency. Return to: The Regency, 3900 Elati Street, Denver, CO 80216.
Accommodations are limited and will be leased on a first-come, first-served basis to qualified applicants. Housing selection requests are not guaranteed. The acceptance of this application does not ensure an accommodation. An accommodation is reserved only upon execution of the Lease Agreement by all parties. Prices are subject to change.
For information or assistance in completing this application, please call (303) 477-1950,or email info@regencystudenthousing.com.

APPLICANT DATA

Name:				Cellular Telephone:
	(FIRST)	(MIDDLE)	(LAST)

Current Local Address: (no P.O. boxes)
	(STREET)	(CITY)	(STATE)	(ZIP)	(YEARS AT THIS ADDRESS)

Previous Address: (no P.O. boxes)
	(STREET)	(CITY)	(STATE)	(ZIP)	(YEARS AT THIS ADDRESS)

Permanent Address: (no P.O. boxes)
	(STREET)	(CITY)	(STATE)	(ZIP)	(YEARS AT THIS ADDRESS)

Please provide the information for one (1) of the items below, and check the corresponding choice:

Driver's License

Passport

State ID

Number:

State:

Social Security Number:

Email Address:

DOB: //

Male Female

Single Married

School Student ID Number:

Current Proposed Major:

Number of Credit Hours:

Current Employer:

Supervisor:

Work Telephone:

Work Address: (no P.O. boxes)
	(STREET)	(CITY)	(STATE)	(ZIP)

Monthly Gross Income: $

Have you filed a Petition for bankruptcy in the last 7 years? Yes No

Emergency Contact:

Contact Telephone:

How did you hear about us?

Have you ever been convicted of a felony? Yes No		If "yes", please explain:
Are you currently or have you ever been on probation, parole, or suspended sentence for any conviction?	Yes No	If "yes", please explain:

Will you need a parking permit? Yes No	Vehicle Make:	Model:
	Year:	License Plate:

HOUSING SELECTION

Rooms will be fully furnished, have private bathrooms, and individual climate control. Rent includes all utilities, basic cable TV, local telephone, and high speed internet access. Monthly rent is per student.

		12-Month Lease		10-Month Lease
Triple	$450		$475
Double	$495		$520
Single	$650		$675
2 Bed 1 Bath	$670
2 Bed 2 Bath	$750

Lease Effective/Move-in Date: Month: Day: Payment Type: Monthly* Semester

Lease term desired: 10 Months 12 Months

*subject to credit approval

Floor Preference: Quiet Floor (double and single units only)

Meal Plan Options For the Fall 2008 and Spring 2009 Semesters (August 11, 2008 – December 13, 2008, and January 19, 2009 - May 16, 2009). Prices below are per semester.

Please Choose One:

19 Meals /week - $1373/semester
                                      15 Meals /week - $1275/semester
                                      10 Meals /week - $1148/semester
                                    7 Meals /week - $835/semester

If you have already chosen your roommates, then please indicate their name(s) below. All roommate choices must be mutual in order to be placed together. Each roommate must complete their own Application for Housing and qualify for housing. If you have not chosen your roommates, please answer the questions below.

1.	2.
3.	4.

1. Do you consider yourself very:
talkative and expressive
quiet and reserved

2. Do you prefer a roommate who:
is very social
not very social

3. Do you prefer music/TV:
loud
quiet

4. Is your living space usually:
very neat and orderly
not very organized

5. Do you prefer to do your homework:
alone
with others

6. Smoking is not allowed in the Regency, are you a smoker?
yes
no

7. If you are not a smoker, are you willing to live with someone who does smoke?
yes
no

8. Do you have asthma or strong allergies to anything?
yes, please list
no

Other Comments:

PARENT/GUARANTOR INFORMATION


(PARENT/GUARANTOR NAME)

Home Telephone:			Cellular Telephone:			Email:
Current Address: (no P.O. boxes)
	(STREET)	(CITY)	(STATE)	(ZIP)	(YEARS AT THIS ADDRESS)

(must provide in order to process application)
(SOCIAL SECURITY NUMBER)	(RELATIONSHIP TO APPLICANT)

Current Employer:

Supervisor:

Work Telephone:


Monthly Gross Income: $	Have you filed a Petition for bankruptcy in the last 7 years? Yes No

BY CLICKING "SUBMIT", I DECLARE AND AFFIRM THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT. I AUTHORIZE THE REGENCY: AURARIA'S STUDENT HOUSING COMMUNITY, LLC OR ANY OF ITS AGENTS TO VERIFY THE ABOVE INFORMATION AND OBTAIN A CONSUMER CREDIT REPORT OF THE APPLICANT AND GUARANTOR NAMED IN THIS APPLICATION. I FURTHER UNDERSTAND THAT AN INCOMPLETE OR INACCURATE APPLICATION IS A REASON TO REJECT THIS APPLICATION.

Note: items marked must be filled out. If you are returned to this page, please check the items marked with stars.