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Print Preliminary Rental Application

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PRELIMINARY RENTAL APPLICATION

The following is a "preliminary application" only. It is intended as a first step in the rental process for customers who found Heatherwood Communities on the internet and have a desire to rent from us.

When we receive your form, you will be contacted by one of our Rental Agents who will take you through the rental process such as showing you available apartments to discussing your rental options, and leasing requirements.

In order to finalize your application, you will be required to complete a formal application for the landlord to obtain credit and other background information.
This preliminary rental application is not a binding agreement.
Name:

___________________________

 Property Name or Location:  (optional)

___________________________
Email Address:
___________________________

 Home Number:
___________________________
Work Number:  (optional)
___________________________

 Fax Number:  (optional)
___________________________
Street Address:
___________________________

 City:
___________________________
State:
______________

 Zip Code:
___________________________

Please specify the best time to contact you
(include Am or PM):
From:  _______________

 To:  _______________

Please check off the best day to contact you. Choose all that apply:
___ Monday   ___ Tuesday   ___ Wednesday   ___ Thursday   ___ Friday   ___ Saturday   ___ Sunday
Please specify the
best way to contact you:

  • ___ Home Phone
  • ___ Work Phone
  • ___ E-mail
  • ___ Via USPS

  • Other  ___________________

 Where do you want to live (town)?

  • ___ Amityville (55 and over)
  • ___ Bohemia
  • ___ Coram
  • ___ East Norwich (Nassau County)
  • ___ Hampton Bays
  • ___ Holbrook
  • ___ Manorville
  • ___ Medford
  • ___ Moriches
  • ___ Patchogue
  • ___ Port Jefferson
  • ___ Ronkonkoma
Please include any comments or Questions that you may have on the back of this printout.
1737 Veterans Highway • PO Box 9008 • Islandia NY 11749 • Phone: 631-234-1600 • Fax: 631-234-1056

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