Online Application

Preferred Store

Store

Renter Information

Renters First Name *

Renters Last Name *

Cell Phone *

Email Address *

Social Sec # *

Drivers License Number *

Street Address *

City *

State *

Zip *

Renter Employer/Income

Renters Employer/Source of Income *

Phone *

Supervisor Name *

Pay Day *

Co-Renter Information

Co-Renters First Name

Co-Renters Last Name

Personal References

Name *

Phone *

Relationship *

Name *

Phone *

Relationship *

Name *

Phone *

Relationship *

Name *

Phone *

Relationship *

RELEASE OF INFORMATION TO Affordable Home Furnishings: (PLEASE READ BEFORE SIGNING)

The Information I(we) have provided on this form is correct. I authorize confirmation of all information that I(we) have provided. Affordable Home Furnishings may contact any person or company that is listed above, and I(we) fully release all parties from all liability from any damage that may result. My(our) Signature(s) below indicate that, for the purpose of confirmation, I(we) have voluntarily waived the protection of all rights to privacy laws. I also agree to accept messages from Affordable Home Furnishings regarding special sales or product offers via US mail, voice, email or text, and understand that I may opt-out at any time. This order may be rejected if any information provided above is found to be false.

FOR RENTER
I am applying for rental, and am over 18 years of age.

FOR CO-RENTER
I am applying for rental, and am over 18 years of age.

Disclaimer: *Restrictions may apply. See store for complete details. Offer expires 10/31/2026.