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The Community at Sunset Wood Application for Residency APPLICATION DATE____________________________ NAME____________________________________________________________________________________ (Last) (First) (Middle) ADDRESS________________________________________________________________________________ (Street) (City) (State) (Zip) BIRTHDATE: MONTH______DAY______YEAR______ SEX_______ SINGLE________MARRIED________SEPARATED________WIDOWED________ HOME TELEPHONE#________________________ SOCIAL SECURITY#_______________________ NEXT OF KIN _____________________________________ RELATIONSHIP_______________________ ADDRESS _______________________________________________________________________________ (Street) (City) (State) (Zip) HOME TELEPHONE#_______________________ BUSINESS TELEPHONE#____________________ YOUR PHYSICIAN____________________________________________TELEPHONE________________ ADDRESS________________________________________________________________________________ YOUR ATTORNEY____________________________________________ TELEPHONE_______________ ADDRESS________________________________________________________________________________ YOUR POWER OF ATTORNEY (P.O.A)______________________________________________________ ADDRESS____________________________________________________TELEPHONE_______________ TYPE OF APARTMENT DESIRED__________________________________________________________ WHEN WOULD YOU LIKE TO MOVE IN?____________________________________________________ NAME(S) OF OTHER PERSON(S) WHO WILL RESIDE IN THE APARTMENT, RELATIONSHIP TO YOU, AGE AND HEALTH PROBLEMS, IF ANY___________________________________________ __________________________________________________________________________________________ SIGNED________________________________________