Rental Application

All fields required unless otherwise indicated.

Full Name*
Phone Number*
Work Phone*
Email Address*
Social Security Number*
Driver's License #*
Date of Birth*
Year in School*
Current Address*
How long at this address?*
Reason for Moving?
Owner / Manager
Owner / Manager Phone #
Parents Name
Parents Address
Parents Phone #
Current Occupation
Employer Phone
Current Gross Income per Month
Other Income Sources
Reference Name*
Reference Phone*
Emergency Contact*
Emergency Contact Phone #*
Vehicle Make, Model, Year
Vehicle License Plate Number
By submitting this form I declare that the statements above are true and correct, and I hereby authorize verification of references given and a credit check.
This is a captcha-picture. It is used to prevent mass-access by robots. (see:
Please confirm that you are not a script by entering the letters from the image.

Wedgewood Hills

Address:1001-1061 East Park St.
Carbondale, IL 62901
Phone: 618-549-5596

Contact Us Rental Application Maintenance Request

Property Features
  • Private Entrance
  • Off Street Parking
  • Fireplace
  • Icemaker
  • Combination Built in Microwave and Hood Fan
  • Gas Forced Air Heat
  • Central Air Conditioning
  • Washer and Dryer
  • 12 Foot Closet Space per Bedroom
  • Trash Disposal, Lawn Maintenance and Snow Removal
  • Garbage Disposer