IT'S YOUR LIFE AT REINHARD VILLAGES

Diane L. Reinhard Villages
159 University Blvd
Clarion,  PA   16214
salesclarion@edrtrust.com

Application Date: April 21, 2014

Fields marked with an asterisk * are required.

 

PERSONAL INFORMATION




        































      





UNIT INFORMATION






      





CRIMINAL HISTORY

*1) Have you ever been convicted of and/or pled "guilty" or "no contest" to any felony regardless of whether such action resulted in jail or prison time served and/or deferred adjunction?

    

*2) Have you ever been convicted of and/or pled "guilty" or "no contest" to any misdemeanor involving theft, burglary, pornography, physical assault, indecent exposure, sexual molestation and/or any unlawful conduct involving a minor, regardless of whether such activity resulted in jail or prison time served and/or deferred adjunction?

    

*3) Are you currently on probation, parole, or suspended sentence for any conviction?

    

 

PARENT / GUARANTOR INFORMATION


















PAYMENT INFORMATION

Application Fee: $ [please select an academic term]

Service Fee: $ [please select an academic term]

TOTAL DUE: $ [please select an academic term]


PAYMENT INSTRUCTIONS:

  1. Click the "Pay Now" button. A new browser tab or window will open where you will be able to enter your payment instructions for our Credit Card handler — Pay Trace.
  2. Enter the "Total Due" amount above into the field labeled "Payment Amount."
  3. Enter "9999" into the field labeled "Apartment Number."
  4. On the following screen you will see a Transaction ID and Date/Time for your payment.
  5. Return to this form to copy-and-paste the Transaction ID and the Date/Time into the corresponding fields below.
  6. Click the Submit button at the bottom of this form once the form is complete.

In order to fully complete your application, you must click the Submit Housing Application button at the bottom of this form once the form is complete.





 

Human Validation



 

DISCLAIMER INFORMATION

The undersigned hereby offers to rent premises on terms and conditions described herein and upon acceptance of this application agrees to sign a rental or lease agreement and pay to all sums due, including required fees. Application fees and other fees are non-refundable. If my application is accepted and I fail to execute the lease agreement or notify management of my intent to cancel in writing within 48 hours, I agree to forfeit the full amount of all fees. The undersigned warrants that the above stated information is true and correct and authorizes verification of such information including, but not limited to, verification of employment, rental history and student status.





   Reinhard Villages is owned by Clarion University Foundation, Inc. and managed by EdR