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International Housing Assistance

1830 Angus Lee Drive
Lawrenceville, GA 30045
Phone: 770.4665383
Toll Free: 866.506.2377
Email Us


Housing Request Form

Today's Date:  
Your Name:  
Name of the Client:  
Apartment Information  
Apartment Size:  
1/1 1den 2/1 2/2 3/2
Floor Preference:  
Number of Occupants:  
Total: # over 18 yrs:
Move in Date:  
Estimated stay:  
Possibly staying longer?:  
Yes No
Consider a 3-month lease?:  
Yes No
Consider a 6-month lease? 
Yes No
*City desired:  
Area desired:  
State desired:  
Familiar with area?:  
Yes No
Purpose of stay:  
Payment method:  
Credit Card Direct bill my company
If you are bringing any animals, how many, what breed, and weight :  
Furniture Options  
Master bed size:  
Guest1 bed size:  
Guest2 bed size:  
Housewares and Electronics Options  
Special house wares requests:  
Washer /Dryer Option  
Do you require a washer & dryer? :
Yes No
Telephone Options  
Do you require telephone service? :
Yes No
High Speed Internet  
Do you require high speed internet? :
Yes No
Cable TV  
Do you require Cable TV? :
Yes No

Special Requests/ Additional Comments:  


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