Country Manor Apartments

Country Manor Apartments Rental Application
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Please use the form below to submit a rental application request. This is not a lease agreement which will be required upon satisfactorily meeting all applicable requirements of Country Manor Apartments rental policy.

Note: Applications will not be submitted for consideration until the security deposit and application fees have been received and processed by Country Manor Apartments.

Requested Move-in Date/Size Information

Please Note that 3 Bedroom Units are NOT currently available. Availability is subject first come first serve as noted by Property Manager list. If you wish to be placed on the waiting list please notify Property Manager upon your arrival.

Estimated Move-in Date

Bedroom Size
1 Bedroom
2 Bedroom

Personal Information Section

First Name

Last Name

Contact Phone

Email Address

Date of Birth

SSN

Address Line 1

Address Line 2

City

State

Zip Code

Country

Employer

Rank (military)

Salary

Spouse/Co-Applicant Personal Information

Note: All residents above the age of 18, that are not full-time students/dependents or spouses are required to remit an additional application fee of $50.00 US.

Spouse or Co-Applicant
None
Spouse
Other

Spouse/Co-Applicant First Name

Spouse/Co-Applicant Last Name

Spouse/Co-Applicant Date of Birth

Spouse/Co-Applicant SSN

Minor Children Residents

Note: Please list all minor children that will reside in the apartment and their ages. If more than three, please contact the office at (337) 537-2220 to obtain prior approval.

Child 1 Name / Age

Child 2 Name / Age

Child 3 Name / Age

Emergency Contact Information

Note: Listing an emergency contact will assist Country Manor Apartments in proper notification in the event of an emergency.

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Relationship

Emergency Contact Phone Number

Note: By clicking the "Submit" button below you agree to have the information contained in this form used to determine your eligibility for renting an apartment at Country Manor Apartments. Upon clicking "Submit" you will be redirected to a payment page where you may pay the $100.00 USD Security Deposit and the non-refundable $50.00 USD Application Fee.

48 Hour Non-Refundable Security Deposit

If prospect cancels move in after having placed a security deposit to hold an apartment (48 hours from date of receipt). The Security deposit will be forfeited to recover cost of holding apartment off the market.

Please fill in ALL lines. Enter N/A or None if a line does not apply to you.

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