Apartment Rental Form

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For office use only: Date received: Dates published: APARTMENT RENTAL FORM A $20 listing fee for each apartment rental is required for non-Clark affiliated landlords. Listings are published on the 1st and 15th of the month (nearest business day if on the weekend/holiday). The $20 fee entitles you to two consecutive publishes. Please note this posting will be published on the Clark University RLH website as well. CIRCLE ONE: APARTMENT FOR RENT SUBLET OR ROOMMATE WANTED: RENTAL ADDRESS: LANDLORD NAME & ADDRESS: CONTACT PERSON: PHONE: _____________________ DESCRIPTION OF RENTAL UNIT Rent per month: Date available: Deposits required: No. of Bedrooms: Yes No Is there an active lodging house license on file for this property/unit? Please check any of the following that are included in your rental: ____ heat ____ electricity ____ water ____ stove ____ refrigerator ____ dishwasher ____ garbage disposal ____ washer ____ dryer ____ laundry hookups ____ fire alarm system ____ security system ____ furniture included: ____ air conditioned ____ garage ____ off-street parking Pets allowed? Which? List any other pertinent information that you would like published: ____ nonsmokers ____ men only I prefer to rent to: ____ women only ____ staff, faculty ____ graduate students ____ undergraduates Please return this form with the $20 listing fee (if applicable) to: Clark University, Office of Residential Life and Housing, 950 Main Street, Worcester, MA 01610. 508-793-7453 (P) 508-421-3787 (fax)

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