Online Application

Email address
Last Name
First Name
Middle
Expected Move-in Date	Select Date
Local Address
Street
City
State	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip or Postal Code
Daytime Phone
Permanent Address
Street
City
State	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip or Postal Code
Country (if not U.S.)
Daytime Phone
Date of Birth	(MM/DD/YYYY format)
Gender	Select... Male Female
Student ID Number
Academic Department Affliation
Department Contact/Advisor
Step 1
Number of people in household
Marital and Children Status	Faculty Staff Single Student (skip to step 4) Married Person w/o Child(ren) (Continue to Step 2) Married Person w/ Child(ren) (Continue to Step 2) Single Parent w/ Child(ren) (Skip to Step 3)
STEP 2
Name of Spouse
Date of Birth	(MM/DD/YYYY format)
Gender	Select... Male Female
STEP 3
Name of 1st Child
Date of birth	(MM/DD/YYYY format)
Gender	Select... Male Female
Name of 2nd Child
Date of birth	(MM/DD/YYYY format)
Gender	Select... Male Female
Name of 3rd Child
Date of birth	(MM/DD/YYYY format)
Gender	Select... Male Female
Name of 4th Child
Date of birth	(MM/DD/YYYY format)
Gender	Select... Male Female
STEP 4
Type of Student	Faculty Staff Undergraduate Senior Graduate Student Non-traditional Student Post-doc Student Visiting Scholar Other:
STEP 5
Type of Housing Desired	Please select one of the following: Studio Apartment One Bedroom Apartment Two Bedroom Apartment "Super 2" Two Bedroom Apartment
STEP 6
Felony Disclosure Statement	Please indicate if you have ever been charged with a crime other than a traffic-related misdemeanor or infraction: Yes No
If yes, please provide a brief explanation of the felony committed, when it occurred, and the disposition of the case.

By submitting my housing application, I agree to the following:

Submission of this application does not guarantee an apartment placement. A security deposit of one month’s rent must be received before any assignment is made permanent. The applicant agrees to update any information that changes on this application. Failure to accept an assignment offered by the E.S. King Village Complex will result in termination of this application and will require a new application be submitted