Penn Commons Application

Apply early for best placement! Apply online or mail to Penn Commons.
Make checks payable to: Penn Commons. Mail to:525 Penn Avenue, Pittsburgh, PA 15222

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Tell Us A Little About You

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Do You Have Someone You Want To Roomate With? Yes No If So Who?
Do You Smoke? Yes No What Kind Of Music Do You Like?
What Is The Best Time For You To Study? Is Your Room At Home Clean Or Messy?
Are You A Gamer? Yes No What Are Your Favorite Games?
Any Special Request or Needs?
Have You Ever Been Convicted Of A Crime? Yes No If Yes, Please Give Us Details:

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Co-Signer Information

First Name: Last Name: Middle Inital:
Address: City: State Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware 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 —- Canadian Provinces —- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Zip Code:
Date Of Birth: Soc. Sec. No. Drivers Licence No.
Cell No. ALT No. Email:
Employer: Your Title: Supervisor Supervisor Phone No.
Employer Address: City: State Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware 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 —- Canadian Provinces —- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Zip Code
Length Of Employment Current Monthly Income
Spouse First Name: Spouse Last Name:
Spouse Date Of Birth: Spouse Cell No.

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Information About Your School and Housing Preferences

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School You Will Be Attending: Start Date:

Room Type	Choose Three	Monthly Rate *
Shared Room With Bunk	First Choice Second Choice Third Choice	Monthly Rate: $325
Standard Private Room	First Choice Second Choice Third Choice	Monthly Rate: $550
Standard Private Room With A Window	First Choice Second Choice Third Choice	Monthly Rate: $565
Standard Private Room Premium View	First Choice Second Choice Third Choice	Monthly Rate: $585
Two Bedroom Graduate Suite	First Choice Second Choice Third Choice	Monthly Rate: $785

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Authorization: I hereby authorize Penn Com I hereby authorize Penn Commons or designee of Penn Commons to run credit and criminal backgrown checks, verification of employment and other such investications defined necessary for the disposition of this application. I further authorize Penn Commons and my school to share information pertaining to financial aid, discipline and student status.Application Feee and mus: Is nonrefundable and must accompany the application to be processed. Deposit: Deposit must be paid prior to moving in. Placements will be set according to when the deposit is received. Written notication of cancelWritten notication of cancellation must be received 30 days prior to move in to receive a full refund. Cancellation of deposits within 15 days of move will be forfited. Incorrect or misleading information on the application may lead to denial of housing.

Your Initials: Send Application :