Lease application

Page 1

Personal data









Additional information








Please enter each name on a separate line



Current living















Background information

MM/DD/YYYY













Parking and vehicle information






Guarantor info















Emergency info






Need assistance with this form? Mosaic is here to help!  You may email leasing@livewithmosaic.com or call our office at 323-733-2258 Monday - Friday between the hours of 10AM - 5PM PST.  We look forward to helping you.

Mosaic has the right to decline an application if any information provided is false.

Page 2

Payment Information






By clicking submit below, you are authorizing payment of $25 non-refundable administrative fee to Mosaic Student Communities.

Need assistance with this form? Mosaic is here to help!  You may email leasing@livewithmosaic.com or call our office at 323-733-2258 Monday - Friday between the hours of 10AM - 5PM PST.  We look forward to helping you.

Mosaic has the right to decline an application if any information provided is false.

Need assistance with this form?