RENTAL APPLICATION. Get Involved

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RENTAL APPLICATION Get Involved To be completed by a potential resident. Please complete this rental application by typing or printing in ink. INCOMPLETE or UNSIGNED applications will not be considered. Email it to info@nationalnov.org. Make sure you enter Rental Application in the subject line. National Network Organization for Veterans, Inc., is an equal opportunity company, and our rental practices are in accordance with the Fair Housing Act. The Fair Housing Act prohibits discriminatory advertising practices in the sale or rental of housing. Advertising may not disclose a "preference, limitation or discrimination" based on any of the protected categories of persons. Qualified applicants are considered for residency without regard to age, race, color, religion, sex, national origin, sexual orientation, disability, or veteran status. If you need assistance or an accommodation during the application process because of a disability, it is available upon request. The company is pleased to provide such assistance, and no applicant will be penalized as a result of such a request. If desired, a copy of our affirmative action plan can be distributed upon request.

Applicant: First M.I. Last Date: Address: Street City State ZIP Contact: ( ) - ( ) - Home Phone Mobile Phone Email Referred By: Currently Employed: Yes No Are you a citizen of the United States? Yes No Are you Homeless? Yes No If yes, may we inquire of your present employer? Yes No If no, are you authorized to work in the U.S.? Yes No Are you looking for something permanent? Yes No If naturalized, date of citizenship and country of birth: Reason for applying? Sex: Female Male Family List everyone who will be occupying the apartment INCLUDE YOURSELF Name of applicant Social Security number Relationship DOB What Branch did you serve: Army Navy Air Force Marine Honorable discharge Dishonorable discharge Years in services Have you ever been convicted of a crime other than a minor traffic violation? Yes No (Note: You are not obligated to discuss sealed or expunged records of conviction or arrest nor will such information be asked of you or considered in employment decisions). If yes, explain:

Do you have a Driver s License? Yes No What is your means of transportation? Driver s license number State of issue Operator Commercial (CDL) Chauffeur Expiration date How did you hear about us? Advertisement Email/Newsletter Employee Referral Facebook Family or Friend LinkedIn Magazine Article Newspaper Story Our Company Website TV/Cable News Twitter Website/Search Engine Youtube Other please explain: Voluntary Information The information is voluntary This information is being requested in accordance with federal regulations. Racial or Ethnic Group American Indian/Alaskan Asian/Pacific Islander Hispanic/Latino White/Caucasian Other African American/Black Gender Male Female Military Service How did you hear about us? Pre-Vietnam Era Newspaper Vietnam Era Post-Vietnam Era Company Employee Disabled Veteran Professional Publication Job Fair Placement Office Website Other

Previous Employment Starting with the most recent employer, list full and part time jobs, summer or volunteer work during the last 10 years. Include periods of military service, self-employment, and unemployment. Please leave no unexplained gaps. Attach separate sheet if necessary. Last or Present Employer Telephone 1 Address Supervisor s Name and Title Job Title Describe your work Employed (Month and Year) From Earnings Start Reason for leaving To Last 2 May we contact this employer? Yes No Last or Present Employer Telephone Address Employed (Month and Year) From Supervisor s Name and Title Earnings Start Job Title Reason for leaving Describe your work To Last 3 May we contact this employer? Yes No Last or Present Employer Telephone Address Employed (Month and Year) From Supervisor s Name and Title Earnings Start Job Title Reason for leaving Describe your work To Last May we contact this employer? Yes No

Education High School College/ University College/ University Trade/Business or Vo- Tech School Other Name of School City and State Major Subject Degree/ Diploma # of years attended List Awards, scholarships, honors received: List professional certifications or designations, and date received: Other special training or skills (machine operation, hobbies, etc.): References (Give the names of three persons not related to you, whom you have known at least one year). Name: Occupation: Phone: Years Acquainted: Name: Occupation: Phone: Years Acquainted: Name: Occupation: Phone: Years Acquainted:

Notifications and useful information: Before coming in for an interview, there are several things that we would like you to be aware of: You must take and pass a drug test before you will be considered for residency. Must be willing and able to present your DD214 for proof you served in the US military. Business casual dress is appropriate and highly recommended for interviews at any of our offices. Because of the safety policy by the National Network Organization for Veterans, Inc., no person can get approval for residency until after the completion of the appropriate security clearances. If you should be selected for an interview, you can help facilitate the scheduling by providing us with the best days and times that you might be available for an interview: Are there any accommodations that we can make to assist you (as a result of any disabilities you might have)? For certification or licensing, please bring your original license with you if you are invited for an interview. I certify that the information provided here is accurate. Signed Date Your Personal History Have you ever? been asked to move out or evicted? Yes No broken a rental agreement or lease? Yes No declared bankruptcy? Yes No been sued for nonpayment of rent? Yes No been sued for damage to a rental unit? Yes No been convicted of a felony? Yes No Your Vehicle Make: Model: Color: License Plate Number: State: In Case of Emergency: Emergency Contact: Phone: Address: City: State:

Do you have any of the following diagnosis or Health problems? (A diagnosis or Health problems will not disqualify you for residency. Rather, such factors as the seriousness and nature of the diagnosis or Health problems, will help us determine which rehabilitation will be considered to enhance and restore functional ability and quality of life to those with physical and mental impairments or disabilities). Post-Traumatic Stress Disorder (PTSD)? Yes No Musculoskeletal injuries and pain Yes No Chemical exposure? Yes No Infectious diseases? Yes No Noise and vibration exposure? Yes No Traumatic Brain Injury (TBI)? Yes No Urologic injuries? Yes No Other? Yes No If other, please explain: I hereby state and represent that the information in this application is complete and accurate. I understand that in the event a lease is entered into it may be cancelled by the Landlord if any of the information provided in the application is materially inaccurate or incomplete. I hereby authorize the Landlord or Landlord s agents to verify the information on the application. Verification or reverification of any information contained in the application will be retained by Landlord. I hereby authorize National Network Organization for Veterans, Inc. to obtain information about me, including, but not limited to, this application, my credit, my tenant history, my check writing history, any court records and/or my criminal record, and I hereby authorize & instruct any entity or person contacted by National Network Organization for Veterans, Inc. or the Landlord or Landlord s agents to release such information to them. Upon request, Landlord, Landlord s agents, or National Network Organization for Veterans, Inc. will provide the name & phone number of the source of the information used in the verification process. Rent Amount: Security Deposit: Lease Term: Move-in date: Applicant: Date: Non-Refundable Application Fee: $ Signature Date: