Leasing Application

You may apply online; or print and mail in your application to us to 3343 Glade Creek Blvd. Roanoke, VA 24012. Be sure to sign the application and to include the application fee and security deposit to reserve an apartment for you. You may also fax us the printed application to (540)985-3098.
*In order to begin processing an online application, an application fee will be required.

Rental Application Fee: $25.00
Security Deposit: $300.00
Ask a marketing associate about sure deposit.

* denotes required field

Personal Information
Full Legal Name:	*
Permanent Address:	*
City:	*
State:	*
Zip:	*
Email Address:	*
Date of Birth:	*
Social Security Number:
Driver's License Number:
Home Phone Number:	*
Cell Phone Number:
Work Phone Number:	*
Present Address:	*
City:	*
State:	*
Zip:	*
Landlord / Mortgagee Name:	*
Phone:	*
How long have you lived at this address?	Years *
Rent / Own?
Monthly Payment:	$ *
Previous Landlord / Mortgagee Name(*If less than two years):
Spouse's Information
Name:
Email Address:
Date of Birth:
SSN:
Driver's License Number:
Additional Information
Do you have any pets?
If yes, please describe:

Emergency Contact Name:	*
Relationship to you:	*
Address :	*
City:	*
State:	*
Zip:	*
Phone Number:	*
Additional Tenants:
Name:
Date of Birth:
Relationship:
Name:
Date of Birth:
Relationship:
Name:
Date of Birth:
Relationship:
Employment Information
Present Employer:	*
Position:	*
Length of Employment:	years *
Immediate Supervisor:	*
Phone Number:	*
Salary:	$ per year*
Address:	*
City:	*
State:	*
Zip:	*
Previous Employer(* If less than two years):
Position:
Length of Employment:	years
Immediate Supervisor:
Phone Number:
Salary:	$ per year
Address:
City:
State:
Zip:
Spouse's Employer:
Position:
Length of Employment:	years
Immediate Supervisor:
Phone Number:
Salary:	$ per year
Address:
City:
State:
Zip
Previous Employer(* If less than two years):
Position:
Length of Employment:	years
Immediate Supervisor:
Phone Number:
Salary:	$ per year
Address:
City:
State:
Zip:
Management expressly reserves the right to reject any application on the basis that an applicant has been convicted by a court of competent jurisdiction of the illegal manufacture, distribution, possession or current use of a controlled substance as defined under applicable federal or state law. Management reserves the right to reject any application on the basis that an applicant has a prior record of a criminal conviction(s) that involved a threat to the health or safety of other individuals. Management reserves the right to reject any application on the basis that an applicant poses a clear and present threat of substantial harm to others or to the dwelling, or property, itself. Management reserves the right to request a copy of applicant(s) Criminal History Record at any time during the application process or residency (if application is approved) at Glade Creek Apartments. I hereby authorize Glade Creek Apartments to request a copy of my Criminal History Record at any time during the application process or my residency at Glade Creek Apartments. Further, I understand and agree that I will reimburse Glade Creek Apartments for the exact cost of requesting a Criminal History Record check.
Have you ever been convicted of a felony that involved a threat to the health or safety of individuals or substantial harm to property? * If yes, explain by indicating the date, nature of any charge, and/or conviction. Also, please state the location in which this act(s) was committed, the location in which the charge and/or the conviction was filed and rendered, and the sentencing issued as a result thereof.
LEGAL ALIENS - 12/30/02 Non-U.S. citizens who have entered the United States legally are eligible to apply for residence at Glade Creek Apartments. In order to qualify, the individual(s) must provide the necessary documentation to verify their legal status, satisfy the current rental criteria and complete the Non-U.S. citizen supplemental application. A visa is proof that a prospect has legally entered the U.S. and the expiration date must not fall within the lease term. If the visa is expired, (or will expire shortly) documentation of a visa extension is required. Every non-U.S. citizen who is legally in the United States for an extended period of time has been issued an alien registration number, this number is required at time of application.
Are you and co-applicant(s) citizens of the United States? *
(If the answer is no, please print out theNon-U.S. Citizen Supplemental Applicationand bring it to the leasing office.) Price subject to change without notice pending full lease execution. An application fee is hereby made in the amount of $25.00 A security deposit is made in the amount of $ 300.00 If this application is not accepted, or if I cancel in writing within 72 hours of acceptance, all monies less the $25.00 application fee will be returned, in accordance with the Virginia Residential Landlord and Tenant Act, Section 55-248.6:1 In all other cases, any monies paid will be forfeited to cover expenses and/or loss of rent incurred by Landlord for my failure to occupy the premises or cancel within 72 hours of application approval. Upon the signing of this application, payment of fees, and subsequent approval of applicant(s) request(s) that the type of rental unit described be removed from those units available for rental. Applicant(s) understand(s) that this application for rental, if approved, becomes part of the lease agreement, even in the event a lease is not signed. I/We certify that I/We are above legal age and that the above information is true and correct to the best of my/our knowledge. I/We hereby authorize owner or agent to verify any and all information as may be deemed necessary for approval or rejection of this application. I/We understand that any lease agreement made on the basis of the above information may be terminated at any time at owner/agent's option if the information provided herein is found to be false. Resident expressly authorizes Landlord or Landlord's Agent (including collection agency) to obtain Tenants consumer credit report, which the Landlord or its agent may use if attempting to collect past due rent payments, late fees or other charges from tenant, both during the lease and thereafter. I understand that everyone 18 years and over is considered a leaseholder and must meet the criteria established for residency at Glade Creek Apartments. If an occupant turns 18 during the lease term they will be required at renewal to fill out all application paperwork. A copy of the criteria used to determine an applicant's eligibility to rent (Glade Creek Rental Criteria) is available upon request. I declare that I have read and understand theapplication criteriadisplayed on this website. * The Lease Agreement was entered into based upon the representations of Resident(s) contained in the Rental Application. If any of those representatives are found to be misleading, incorrect or untrue, Landlord may immediately terminate this Lease Agreement and notify Resident(s) to vacate the Premises. Electronic Signatures In Lieu of an original signature to this agreement, landlord will accept a valid and legitimate electronic signature and/or facsimile signature of the resident. In doing so, resident hereby acknowledges his/her endorsement and acceptance of this agreement, and he/she waives any challenge to validity of this agreement based on resident's endorsement by electronic and/or facsimile signature.
Applicant's Signature: *	Spouse's Signature


* denotes required field

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Leasing Application