Application

Applicant Personal Information
Name				DOB		DL#
Gender	Male Female	SS#		Marital Status		Phone
Spouses Name				Spouse DOB		SS #
E-mail

Other Residents Living With You
Do you have a roommate? YES NO (if yes please enter information below)
Name				DOB (mm/dd/yyyy)
Relationship

Residence History For Last Two Years
First Residence
Address				City	State
Rent		Landlord Name		Phone
Moved In		Moved Out
Reason for Leaving
Second Residence
Address				City	State
Rent		Landlord Name		Phone
Moved In		Moved Out
Reason for Leaving

Employment History For Last Two Years
First Employment Record
Company Name						How Long
Address				City		State
Position		Income		Supervisor		Phone
Second Employment Record
Company Name						How Long
Address				City		State
Position		Income		Supervisor		Phone

Bank References
Bank		Branch		Telephone		How Long?
Check Acct #				Saving Acct #
Transportation
Type Of Auto		Color		Tag No.		County, ST
Who Financed?			Acct #			Mo. Payment

Payment Information
You will need to bring a check to our Clubhouse or mail a check in the amount of $50.00 to Summit of Athens Office 1035 Barnett Shoals Road Athens, GA 30605.
Parent or Sponsor Guaranty
Parental Guaranty required for all dependent applicants. Parent must sign with a Notary and submit by fax or mail. Download and Print PDF Now