ABOUT
MISSION
BUILDING THE VILLAGE
LEADERSHIP
TEAM
FEATURED STORIES
ANNUAL REPORT
SUPPORT
DONATE
DONOR PARTNERS
PLANNED GIVING
CAPITAL CAMPAIGN
LIVING AT THE VILLAGE
RENTAL INFORMATION
AMENITIES/RESOURCES
RESIDENT STORIES
EVENTS
GOLF OUTING
TASTING FOR THE TROOPS
CONTACT
DONATE
ONLINE RENTAL APPLICATION
Additional info can go here if needed
APPLICANT INFO
Name
*
Middle name
*
Last name
*
Address
*
City
*
State
*
Zip code
*
Cell phone
*
Work phone
*
Email Address
Social Security Number
*
Date of Birth
*
List ALL states in which you have previously resided
*
Additional residents (please list all that will live within the apartment)
First name
Middle name
Last name
Date of birth
Social security number
Gender (as listed on government issued ID)
Male
Female
Veteran/Military status
List ALL states in which this person has resided
PETS
List all pets
Type
Is your pet spayed/neutered?
Yes
No
Not applicable
Is your pet current on all vaccinated?
Yes
No
Not applicable
Upload pet license and records
Drag and Drop (or)
Choose Files
Other information regarding your pet and any answers given above?
RENTAL HISTORY
Landlord business name
Current Landlord name
Landlord phone
Landlord address
rented since
PREVIOUS RENTALS
Previous landlord business name
Landlord name
Previous landlord phone
Landlord address
Rented from
INCOME SOURCE(S)
List ALL sources of income
Include all that is applicable including: interest/dividends, child support, social security, SSI, VA pension, retirement pension(s), other
Household member name
Employer/income source name
Employer/income source address
Employer/income source phone
Monthly income
ADDITIONAL INFORMATION
Has anyone listed in the resident section ever been evicted from rental housing?
*
Yes
No
If yes, please explain
Has anyone listed in the resident section ever been convicted of a felony or other criminal act other than a traffic violation?
*
Yes
No
If yes, please explain
Has anyone listed in the resident section ever been charged with possession, manufacture or sale of illegal drugs?
*
Yes
No
If yes, please explain
Has anyone listed in the resident section ever been required to register on any Sexual Offender Registry list?
*
Yes
No
If yes, please explain
5. If you are disabled, is your sole disability due to drug addiction or alcoholism?
*
Yes
No
Not applicable
Does anyone listed in the resident section require the use of a unit that is specifically designed for wheelchair accessibility?
*
Yes
No
Do you have a housing voucher?
*
Yes
No
If yes, which agency provides voucher?
ADDITIONAL CONTACTS
Please list two people we can call if you cannot be reached.
Name
*
Phone
*
Name
*
Phone
*
REQUIRED DOCUMENTS
Please upload the required application documents below.
Veteran: DD214 letter
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No file chosen
Delete uploaded file
Social Security Card
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No file chosen
Delete uploaded file
Copy/picture of government-issued ID or Drivers license (must include photo of primary applicant)
Choose File
No file chosen
Delete uploaded file
Copy of most recently filed tax return
Choose File
No file chosen
Delete uploaded file
AFFIRMATION OF APPLICATION INFORMATION
I/We certify that all of the above information is true and correct. I/We have no objections to inquiries being made for the purpose of verifying the statements made herein as well as verifying military service, checking my/our credit, landlord reference(s) and criminal history. I/We understand that I/We can be denied housing up to five years if I/We knowingly furnish false or incomplete information.
OPTION – A $26.00 non-refundable fee must be submitted with this application. Which way would you like to pay?
Payment via credit card (Recommended. Use field below for payment)
Send/drop off check or money order at WisVVA, 2919 W. Glenpark Dr., Suite #500, Appleton
A $26.00 non-refundable fee must be submitted with this application. Pay using credit card below.
*
Submit Application
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