Apply - The Lodge

Legal Name*
First Last
Home Address*
Street Address Address 2 City State Zip
Birthday*
MM slash DD slash YYYY
Social Security Number*
Phone*
BYU-I Email*
Personal Email*
Gender*
- Male
- Female
Are you currently 18 years or older?*
- Yes
- No
Semester / Year*
Apartment Layout Mens
Apartment Layout Womens
Roommate Request (Optional)
Second Semester (optional), $50 off both leases
Please only select this option if you are wanting to sign for multiple semesters. If selected, your second semester will qualify you for $50 off each lease
Emergency Contact*
First Last
*Must be a legal guardian if you are under 18*
Emergency Contact Phone*
Emergency Contact Email*
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