* Indicates a required field.
First Applicant's Name: * Date of Birth: *
Second Applicant's Name: Date of Birth:
Marital Status: * SingleMarriedPartneredDivorcedWidowed
Ethnicity: * Hispanic or LatinoNon-Hispanic or LatinoI prefer not to disclose
Racial Category (check all that apply): * American Indian or Alaska NativeAsianAfrican AmericanHawaiian or Pacific IslanderCaucasianI prefer not to disclose
Do you currently: * OwnRentLive in a retirement communityLive with family
Present Landlord or Mortgage Company: Phone:
Monthly Rent/Mortgage Payment: Date of Move-In:
How soon are you contemplating a move? * ASAP3-6 months6-12 months1-2 yearsUnknown
Will you be parking a vehicle on the property? * YesNo
Do you own a pet? * YesNo Breed: Weight:
Do you currently receive housing assistance? (i.e. Section 8) * YesNo
Do you currently live in subsidized housing? * YesNo
How did you hear about Golden West?
* Golden West is required by the State of Colorado and City of Boulder to collect copies of income tax returns from residents and if not required to file a tax return, other third party verification of income must be provided such as Social Security statement and/or bank statements.
Alternative Contact: Relationship:
Please select the type of apartment you would prefer studio, one-bedroom or both. Keep in mind that very limited preferences can prolong the waiting time.
1st Available Either TowerCentral Tower EastCentral Tower SE CornerCentral Tower West
Central Tower SW CornerSouth Tower NorthSouth Tower South
South Tower East EndSouth Tower West EndSouth Tower SE Corner
1st Available Either TowerCentral Tower EastCentral Tower West
Central Tower NW CornerCentral Tower NE CornerSouth Tower NW Corner
South Tower SW CornerSouth Tower North
Would you like to request a certain floor?
Any other requests?
Bank Name: * Phone: *
Address: * Checking Account Number: *
List all credit obligations with minimum monthly payment: *
Have any of the applicants broken a lease? * YesNo
Declared bankruptcy? * YesNo
Have any of the applicants ever been convicted of a felony? * YesNo
Have any been convicted of a violent crime? * YesNo
Please type the code below.