Star Appliance Rental: Providers of Stack and Full Size Washer Dryers and Refrigerators for the Rental Industry.

Serving the Houston Apartment Community since 1984

We accept all major credit cards.

Residential Customer Order Form

APPLICANTS INFORMATION
	* Indicates Required Field
* Name:
* Delivery Address:
* City:
* State:
* Zipcode:
* Home Phone:
Alternate Phone:
* Email Address:
Current Landlord:
Landlord's Phone:
Previous Address:
Previous City:
Previous State:
Previous Zipcode:
* SS#:
* DOB: (MM/DD/YYYY)
* TDL#:
Referred By:
APPLICANTS INFORMATION
* Employer:
Employer's Address:
City:
State:
Zipcode:
Job Title:
* Work Number:
Hire Date:
Shift:
Dept:
* Take Home Pay:
Additional Income:
Source:
SPOUSE/ ROOMMATE INFORMATION
Name:
SS#:
DOB: (MM/DD/YYYY)
TDL#:
Home Phone:
Alternate Phone:
Spouse/Roommate Email:
Employer:
Employer's Address:
City:
State:
Zipcode:
Work Phone:
Job Title:
Take Home Pay:
Addt'l Income:
Source:
REFERENCE INFORMATION
* Name1: (Closest Relative)
* Address:
* City:
* State:
* Zipcode:
* Home Phone:
* Work Phone:
* Relationship:
REFERENCE INFORMATION
Name2:
Address:
City:
State:
Zipcode:
Home Phone:
Work Phone:
Relationship:
DIGITAL SIGNATURE
* Digital Signature:
By digitally signing this application form, you are authorizing us to obtain your credit bureau report.

Please only click "Submit" once. Allow up to one minute for form to process. Thank you.

For further information, please contact Tommy Aleman or Kelly Lara at (281) 277-7169.