Apartment Rental Application



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Name: Spouse/Roommate: Address: City: State/Zip: Telephone: Home Work: Fax: Move-In Date Requested: Please Circle One of the Following: Medical Student MSTP Student Graduate Student Post-Doctoral Research Post-Doctoral Clinical Other (list department) Allied Health Student Resident Junior Faculty Floor Plan Preference - Please number 1-5 with 1 indicating your first choice (While we cannot guarantee you will get your desired floor plan or apartment location, we will make every attempt to accommodate your request.) One Bedroom: Two Bedroom: Floor Plan A1 (654 sq.. website, dept, friend) Office Use Only Deposit ReceivedByDate Apartment Number Assigned ByDate Rent AmountLease Dates To Administration Approval:Date 1) To apply for housing in the Southwestern Medical Park Apartments you must complete a Rental Application Form and submit your 25.00 non-refundable application fee to: Southwestern Medical Park Apartments Leasing Office 6401 Maple Avenue Dallas, TX 75235-5505 2) Please note: A 25 Non-refundable application fee is required with the submission of a Rental Application Form in order for your name to be placed on the waiting list for an apartment..  

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