Application

Please complete all requested information of this form. Thank you for your interest.

At this time, you are able to apply for an apartment in the first building (current), second building (not yet built, projected Summer 2027), or the first available option.

Apartments are offered for rent without regard to race, color, religion, sex, national origin, disability, or familial status.

Applicants Checklist

A completed application requires the following be submitted with the completed application

Payment of $25 application fee (payable to Alder Springs Deaf & Blind Community)
Criminal background report
Independent Living Declaration (printable document)
Applicants General Authorization Statement (printable document)

Resident Application for Alder Springs

Applicant Information

*Building Choice(required)

*For more information on the Alder Springs apartment buildings, refer to the Plans page or Capital Campaign page.

First name(required)

Middle name

Last name(required)

Date of birth(required)

Co-Applicant's first name

Co-Applicant's middle name

Co-Applicant's last name

Co-Applicant's date of birth

Additional resident info

Full names and dates of birth for additional residents. ex. John Doe - 03/22/1980, Jane Doe - 02/25/1983

How many pets

Pet information

Please list kind of pet, breed, weight, and age for each pet

Occupancy date(required)

Apartment design(required)

Note: studio only available in 2nd Building. For more information on the Alder Springs apartment buildings, refer to the Plans page or Capital Campaign page.

Bath design(required)

Residence History

Present Residence

Present email

[email protected]

Present vp phone

000-000-0000

Present voice phone

000-000-0000

Present street(required)

Present city(required)

Present state(required)

Present postal(required)

Length of time at address(required)

Present landlord name

Present landlord phone

000-000-0000

Present monthly payment

Present reason for moving(required)

Previous Residence

Previous street

Previous city

Previous state

Previous postal

Residency period

mm/year - mm/year

Previous landlord name

Previous landlord phone

000-000-0000

Previous monthly payment

Previous reason for moving

Employment History

Present Employment

Present employer

Present from date

mm/year - present

Present employer address

Present employer phone

000-000-0000

Present position held

Present supervisor name

Present gross mo salary

Previous Employment

Previous employer

Previous from date

mm/year

Previous to date

mm/year

Previous employer address

Previous employer phone

000-000-0000

Previous position held

Previous supervisor name

Previous gross mo salary

Co-Applicant Employment

Co applicant employer

Co applicant from date

mm/year - present

Co applicant employer address

Co applicant employer phone

000-000-0000

Co applicant position held

Co applicant supervisor name

Co applicant gross mo salary

Vehicle Information

Total number of vehicles

Including company vehicles

Vehicle 1

Vehicle 1 make model

Vehicle 1 year

Vehicle 1 color

Vehicle 1 tag state

Tag Number and State

Vehicle 2

Vehicle 2 make model

Vehicle 2 year

Vehicle 2 color

Vehicle 2 tag state

Tag Number and State

Additional Vehicles

Vehicle additional information

Information on any additional vehicles (Car, Motorcycle, etc.)

Income Information

Total gross monthly income(required)

List all means of regular income you want considered below.

Income 1

Income amount 1(required)

Income amount per 1(required)

Income source 1(required)

Work, Investment, etc

Income phone 1

000-000-0000

Income 2

Income amount 2

Income amount per 2

Income source 2

Work, Investment, etc

Income phone 2

000-000-0000

Income 3

Income amount 3

Income amount per 3

Income source 3

Work, Investment, etc

Income phone 3

Additional Income Information

Other sources of income

Applicant is not required to reveal alimony, child support, or spouse/partner annual income unless applicant wants it considered

Comments on monthly income

Including expected changes to monthly income

Rental History

Has the Applicant or Co-Applicant ever (check if yes):

Been sued for non payment

Been evicted or asked to leave

Broken rental agreement or lease

Been sued for property damage

Declared bankruptcy

Emergency Contact Information

Emergency notify name(required)

Emergency address(required)

Emergency notify relationship(required)

Emergency phone(required)

000-000-0000

Emergency vp

000-000-0000

Additional Documents

The following documents are required to fully submit your application. Please click each link below and follow the directions provided.
Independent Living Declaration Summary - sign online
General Authorization Statement - sign online

I understand that both documents must be fully signed and submitted in order for my application to be complete(required)

I hereby make application for an apartment and certify that this information is correct. I authorize you to contact any listed references. I also authorize you to obtain my consumer credit report from a credit reporting agency and my criminal background report. I understand that these reports will appear as inquiries in my file.

Applicant signature(required)

Co applicant signature

Date signed(required)

Credit or Debit Card

A $25 application fee will be charged to your card.