Roommate Request Form

Please complete the form below and click "SUBMIT REQUEST." * Required Fields.

first name*:
last name*:
email address *:
retype email address *:
contact phone number*:
your gender*
Male
Female
You are willing to live with:*
Male
Female
Either
Are you willing to share a room?*
Yes
No
Either
Is it ok for the prospective roommate to contact you?*
Yes
No
Either
Number of parking spaces?*
0
1
2
3 or more
How did you hear about us?*
Employees
Internet
Other
Family/Friends
Mail
Google Search
Flyers
Newspaper
Lease Start Date?
Lease End Date?
Comments / Questions*
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We Do Business In Accordance With The Federal Fair Housing Law Equal Housing Opportunity

3036 S. Hoover
Los Angeles, CA 90007

Phone: 213-765-3330
Fax: 213-747-1516

Office@firstchoicehousing.com

Copyright © 2011 First Choice Housing.
All Rights Reserved.
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