First Name
*
Last Name
*
Phone
*
Email
*
Emergency Contact (Name / Relation / Number / Email)
*
Which home are you interested in?
*
Arthur’s Place / Chupp’s Place / Zachary’s Place / No preference
Which room type are you interested in? (bathroom preference)
*
Select option
How did you hear about us?
*
Website form, Zillow, referral sources, etc.
Who referred you?
Who will be living in the room?
*
Just Me
Me and Someone Else
Is your additional occupant over the age of 18?
*
Yes
No
N/A - Just Me
Total number of occupants
*
Total monthly income before taxes
*
Monthly room budget (including utilities)
*
How many months do you plan on staying?
*
Select an option
Have you rented before, or are you currently renting? Location, rental period, landlord name & contact
*
Please explain the circumstances of the last place you lived and why you moved out
*
What is your work history over the past 2 years?
*
Please list at least one reference (Name / Relation / Number)
*
Have you lived in a multi-tenant / shared house before?
*
Yes
No
Do you have pets?
*
Yes
No
ESA/Service Animal
What kind of pet do you have?
Do you smoke/vape?
*
Yes, and I agree to smoke/vape outside property
No
Which personality type are you primarily?
*
Introvert
Extrovert
Any pet peeves we should know about living with others?
*
Do you have a vehicle?
*
Yes
No
Vehicle color
Vehicle license plate number
Photo of license plate
Click to upload
Which area(s) are you interested in living in? (include zip codes)
*
Desired move-in date
*
Selfie with your face and ID in the same photo
*
Click to upload
Text Consent (form)
By checking this box, I consent to receive non-marketing text messages from Stay Cozy Living about my room inquiry: customer care replies, tour scheduling and reminders, and application and move-in updates. Message frequency varies. Message and data rates may apply. Text HELP for assistance, reply STOP to opt out. Consent is not a condition of renting.
Marketing Text Consent (form)
By checking this box, I consent to receive marketing and promotional messages about room availability from Stay Cozy Living at the phone number provided. Frequency may vary. Message and data rates may apply. Text HELP for assistance, reply STOP to opt out. Consent is not a condition of renting.
Submit
Privacy Policy
|
Terms of Service