Palmer College of Chiropractic, Current Student, Housing List Form

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Palmer College of Chiropractic

Current Students

Listing Addition Form

If you would like your listing to be included on the Palmer College Housing List, please complete and submit the following form. If you have any questions or concerns, please contact Melissa Carlson, Office Assistant, at (563) 884-5643. Your listing will remain posted for six weeks unless we hear from you to cancel or extend the ad. Thank you!

Your Name:
Your Phone Number(s):

For Rent For Sale Roommate Wanted

Address of Unit:

Please check here if this ad is currently on our website and you would just like to renew it or update some of the information. Please only enter new or additional information below. Thanks.

Type of Dwelling:

	Apartment
	Upper Level Ground Level
	Condo
	Townhouse
	Duplex
	Side-by-Side Up-and-Down
	House
	Mobile Home

Number of Bedrooms:

None (efficiency)
One
Two
Three
Four

Number of Bathrooms:

One
One-and-a-half
Two
Two-and-a-half

Rent: /month

Deposit:

Date Available:

Who Pays the Following Utilities?

	Landlord	Tenant
Water:
Electricity:
Heating:
Cooking Gas:
Phone:
Cable:
Sewer:
Trash:

Please check any of the following features that apply:

	Central AC
	Window AC Units
	Ceiling Fans
	Window Coverings
	Stove
	Refrigerator
	Dishwasher
	Garbage Disposal
	Microwave
	Washer and Dryer
	Washer/Dryer Hook-ups
	Coin-operated Laundry

Please Answer the Following Questions:

	Yes	No
Are Pets Permitted?
Is Smoking Permitted?
Is a Lease Required?
Is there a Garage?
Is there Off-Street Parking?
Is there a Basement?
If so, is the basement finished?
Is there a Patio or Porch?
Is Storage Space Available?
Is there a Swimming Pool?
Is there a yard?
If so, is the yard fenced?

Any Additional Comments:

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Palmer College of Chiropractic
1000 Brady Street, Davenport, IA 52803-5287
Phone: (800) 722-3648 or (563) 884-5656 | Fax: (563) 884-5414
e-mail: pcadmit@palmer.edu