Thank you for your interest in Park Lane Villa. To better suit the needs and desires of potential Park Lane Villa tenants, we kindly ask that you complete the form below. All information provided is confidential and therefore, will not be shared with any third party.

Where are you currently residing?
When are you expecting to move?
What would make residency at Park Lane Villa more attractive to you?
Size of apartment you're considering?
Floor:
One Two Three Four Five Six
Preferred Apartment Number:
Number of bedrooms
One Two Three
Parking:
Outside Parking Need Covered Parking
How did you hear about Park Lane Villa?
Through University Circle, Inc.
Referred by a friend
Saw program ads
Visited website
Through my employer
Other - Please Specify
Received your mailings
Stopped by your booth at a University Circle event
Through Case Western Reserve University
Saw the sign
Received your email
How would you best describe your current lifestyle  (Please check all that apply):
Urban professional
Artist
Musician
Writer
Corporate Career
Humanities
Physician
Attorney
Accounting
Culture lover
Arts Music Museums Theatre
Sales & Marketing
Public Relations
Healthcare
Outgoing
Quiet
Active
Other - Please Specify
Where are you currently employed?
Undergrad Grad student
Please provide us with your monthly income. (All information will be held with strict confidence)
If you are a student, what college do you attend?
Please provide us with your contact information:
Name:  
Current Address:  
Day Phone:  
Evening Phone:  
Cell Phone:  
E-mail Address:  
Best time of day to contact you: