Leasing Application

You can submit a rental application by completing the form below.  If you have any questions or would like to schedule a time to sign a lease, please call us at 217-359-6108.

*JSM requires a lease application before we can schedule a lease signing appointment.
*JSM will no longer be accepting cash payments.

Note: * denotes required field

Background Information

Campus / Location you are applying for

Name ( first, middle, last )

Social Security Number ( 999-99-9999 )
I have no Social Security Number
- -

?
Why do we need your SSN?
Your social security number is sent via a secure connection and used solely to verify your identity and determine credit worthiness; it will not be used for any other purposes.

Driver's License Number
I have no Driver's License Number

Date of Birth ( mm/dd/yyyy )
/ /

Current Information

Current Address (U.S. address only)

City, State, Zip, Country
,

Cell Phone ( (999) 999-9999 )
( -

JSM communicates with residents primarily via email.
Please ensure your primary email is entered here correctly

Email

Secondary Email

Permanent Information

Permanent Address (U.S. address only)

City, State, Zip, Country
,

Phone ( (999) 999-9999)
( -

School Information

Are you a student?
No Yes

Year

School

Major

Emergency Information

Emergency Name (In the U.S. Please)

Relationship

Address (U.S. address only)

City, State, Zip
,

Email

Phone ( (999) 999-9999 )
( -

Cell Phone ( (999) 999-9999 )
( -

Verification Information

Type of current residence?
Landlord
Dorm
Fraternity
Sorority
Parents
Other

Other

If currently renting from landlord.

Name

Office Address (U.S. address only)

City, State, Zip
,

Phone ( (999) 999-9999 )
() -

Survey

How did you hear about JSM? (check all that apply)
Daily Illini U of I Tenant Union Sign on Building
Acquaintance Housing Fair Search Engines
JSM Vehicles
Other:

Credit/Reference Check Permission

Click here to grant JSM permission to conduct a credit check and/or previous residence reference check.
* This is required to process your application.
I hereby give JSM permission to perform a Credit/Reference Check using the information supplied on this lease information form.