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�.-_--....-- -- - T • <br />LAKESIDE CENTER INC. � _ I <br />Return To: <br />LAKESIDE CENTER INC. <br />P.O. BOX 1704 <br />DICKINSON, TX 77539 <br />281-534-1504 • FAX 281-534-1504 <br />APPLICATION <br />YYIIV YYIII IIVO III ally o W- 4...v.... <br />Full Name <br />Relationship <br />Birth Date <br />Sex <br />Soo. Sec. # <br />• Full -Time <br />Student <br />`A full-time student is detinea as someone wno nas oveii vl wlll U0 Q IY11-LI1110 Owe W <br />months -this year, not necessarily consecutive. <br />Current home address: I <br />Home phone no.: Work phone no.: I <br />A. GENERAL INFORMATION <br />1. Do you have the right to legally enter into a lease? YES NO <br />2. Please state the name(s) of any household member(s) that you want to be made Co-Head(s)• <br />(Co -Head is defined as an individual who has the legal right to enter into a lease agreement <br />and will share all the rights and responsibilities.) <br />3. Have you ever been convicted of a felony? YES NO If yes, please explain: <br />:'nrw,rinl�� FT 111iw.nnrs�"� O. r`r►rwn�sn�, 1 1 17 j-/ 94 4;^A ngskIL+ A&.-^..rnh.+M <br />