The Last Resort - Rent your home

phone: (800) 409-7946
fax: (336) 886-6646
info@furnituremarkethousing.com

New Record

Please fill out information below to have someone contact you regarding renting your home for market or short term housing.
Zone:

( click here to see zone map )

Note: ** We will be unable to rent your home if it is outside of our specified zones.

Distance to market:

miles.

Name of Subdivision:

First Name:

Last Name:

Address:
City:	State:	Zipcode:

Home / Cell Phone:

Work Phone:

Fax Number:

Email:

# Bedrooms:

Single:

Double:

Queen:

King:

*Other:

# Bathrooms:

# Half Bathrooms:

Year house was built:

# Square Feet:

# TV's: Cable Satelite DVD High speed Internet

Central Air Window Unit

Fully Equipped Kitchen

Do you own pets?:
If you answered yes to the previous question, what type of pet / pets do you have?: Cat Dog Bird
Note: * All animals must leave the premises during rental.*

Do you smoke?:

Style of house:

Patio or Deck?:

Grill?:

Cost:

Per:

Remarks:
Please include an emergency number where you can be reached at all times.

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