Email Personal Information First Name * Last Name * Birth Date * Social Security Number * Student ID Mobile Number * Email Address * Driver License Number License Driver State - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Building Preference 620 Landfair Ave (DS Summer Only) 515 Gayley Ave (ATO) 555 Gayley Ave (ZBT) 629 Gayley Ave (TX) 649 Gayley Ave (DTD Summer Only) 10938 Strathmore Dr (PKS) 440 Veteran Ave 2715 Portland St (USC) 9934 Zelzah Ave (CSUN) Leasing Period * Current date to 6-18-23 (remainder of UCLA academic year) 6-23-23 to 6-16-24 (UCLA summer and academic year) 6-23-23 to 9-17-23 (UCLA Summer) Unit Preference Desired Move-in-Date * Current Address * Address Line 2 City * State * Zip Code * Country * Current or Previous Landlord Landlord Phone Employment Information Current Employer Employer Phone Position/Job Title Date Started Gross Monthly Income Rental and Credit History Have you ever filed for bankruptcy ? * Yes No Have you ever been served an eviction notice ? * Yes No Have you ever intentionally refused to pay rent ? * Yes No Additional Notes Here Type your SSN again to grant permission to run your credit and background check *
