(Please fill out entire form so as to provide our students with complete and accurate information.) Landlord Information Landlord"s Name Email Street City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Phone Cell General Information Anticipated openings for Fall (Aug-Dec) Spring (Jan-May) Summer (June-Aug) Address of Housing Street City Number of students I can accommodate Miles from campus (approx) Type of Housing Details of Housing Kitchen Privileges from housing owner Own Kitchen Shared Bathroom with housing owner Own Bathroom Washer Dryer Linens Private Entrance Parking Meals Provided None Breakfast Lunch Dinner Weekdays Weekends Rent (per student) Monthly Weekly Semester Security Deposit Utilities Included Yes No If “No” please indicate approximate costs per month and payment procedure Facilities for Handicapped Yes No Additional Information CAPTCHA Submit
Housing Options For more info, visit Commuting to Campus and Off-Campus Housing or contact the Office of Student Affairs at (570) 675-9279 or [email protected].