First Name*:
Last Name*:
Email*:
Day Phone*:
Evening Phone*:
Best Time to Call:	Any Day Weekday Weekend     Anytime Morning Afternoon Evening
Type of Housing Desired:	- Select One - Apartment Commercial Duplex Fourplex House Loft Apartment Mobile Home Townhome Triplex
Desired Move-in Date:
Desired Length of Lease:	- Select One - 6 months 9 months 12 months other   Other:
What is your monthly rental budget?	Less Than Equal To Greater Than
Where would you like to live?	- Select One - College Station Bryan Close to Campus
How Many Occupants?	- Select One - 1 2 3 4 5 6
How Many Bedrooms?	- Select One - 1 2 3 4 5 6
Are You a Student?	Yes No   If yes, what school?  - Select One - Texas A&M Blinn College
Do you need shuttle bus service?	Yes No
Upstairs?	No Preference Studio Upstairs Downstairs
Will you be bringing any pets?	Yes No
How did you hear about us?	- Select One - Internet The Eagle The Battalion La Vos Hispana Sign on Site Friend Drive By Yellow Pages Other   Other:
Have you worked with a leasing agent in our office before?*	Yes No   If so, who?
If you were referred to us by a current resident of United, will you share their name with us?