Rental Application

Download our lease application in PDF Format
Applications can be dropped off or mailed to 1147 South Division Street, Salisbury, MD 21801

Please fill in this form completely
to apply for a lease with Salisbury Housing

Desired Address to lease :
Date of Occupancy :	(mm/dd/yy)
Length of Occupancy :
Your Information
Your First Name :
Middle Name :
Last Name :
Social Security Number :	(no dashes)
Date of Birth :	(mm/dd/yy)
Home Phone # :	(no dashes)
Cellular Phone # :	(no dashes)
Your Email Address :
Transportation Information
Drivers License # :	(Include State)
Vehicle Tag # :
Make :
Model :
Year :
Color :
Current Residence Information
Current Address :
City :
State :
Zip Code :
How Long Have You Lived There? :	(years)
Living Status :
Landlord/Mortgage Holder :
Landlord/Mortgage Holder Phone # :	(no dashes)
Landlord/Mortgage Holder Address :
Reason for Leaving :
Employment Information
*If you are a full-time student, please put "Full-Time Student", if you are a part-time student please put "Part-Time Student"
Employer :
Employer Phone :	(no dashes)
Employer Address :
Type of Business :
Position :
Date Employed :	(mm/dd/yy)
Yearly Salary :
Other Income Source :
Other Salary Per Year :
Parent/Co-signer Information
Name :
Home Phone :
Social Security Number :
Date of birth :
Address :
City :
State :
Zip Code :
Employer :
Phone number :
Address :
Type of business :
Position :
Date Employed :
Salary :
Other income source(s) :
Salary :
Emergency Contact Information
Nearest Relative Name :	(not living with you)
Relationship :
Address :
Phone Number :	(no dashes)
Roommate Information
Roommate Name :
Phone Number :

Roommate Name :
Phone Number :

Roommate Name :
Phone Number :

Miscellaneous Information
Character Reference :	(non-related)
How did you learn about SalisburyHousing.com? :
Why are you choosing SalisburyHousing.com? :
If there are any handicap accessible enhancements you may need please list them here. :

Rental Application

Download our lease application in PDF Format Applications can be dropped off or mailed to 1147 South Division Street, Salisbury, MD 21801

www.SalisburyHousing.com

Download our lease application in PDF Format
Applications can be dropped off or mailed to 1147 South Division Street, Salisbury, MD 21801