Student Housing Application

Bishop House · Active Sports Therapy

Basic information

Legal first name *Legal middle nameLegal last name *Preferred nameEmail *Mobile phone

Permanent mailing address

Internship & housing dates

School / institutionProgramInternship startInternship endRequested move-in *Requested move-out *

My move-in date is flexible My move-out date is flexible

Room preference Master — private bath · $800/mo T1 — shared bath · $500/mo T2 — shared bath · $500/mo I’m open to another room if my first choice isn’t available I’m interested in sharing the Master SuiteRequested roommate (if any)Accessibility needs or accommodations

Vehicle (required by the HOA)

MakeModelYearColorLicense plate

Emergency contact

NameRelationshipPhoneEmail

Pets

Bishop House does not currently allow pets.

No, I do not have any pets Yes, I have a pet

Allergies & notesAllergies or sensitivities (cleaning products, etc.)Special requests or additional notes

Policy acknowledgments

All are required. Submitting an application does not guarantee availability; a room isn’t secured until the lease and required payments are complete.

Housing fees are due on the 1st of each month; a 10% late fee applies if not received within 5 days of the due date. I will keep my space clean and leave it broom-swept upon departure. The property is shared; I will respect quiet hours and common areas. I will not hang or mount anything on the walls. I will provide my own consumables (toilet paper, soap, etc.). I will not illegally download or tamper with internet equipment. AST and JACE LLC are not responsible for lost or damaged personal items. My deposit, first month's rent, and signed lease are required before move-in. I will notify AST if I'll be away from the home for more than 7 consecutive days.