Housing Application

FLUSHING HOUSE CLUB RESIDENCE | Flushing, New York 11358 | 38-20 Bowne Street

Thank you for your interest in Flushing House. We are pleased that you are considering making your home with us. The application process requires the following before your application can be evaluated:

  • Application Form
  • Application Processing Fee ($50.00 /non-refundable)
  • Financial Disclosure Form with required attachments
  • Guarantor’s Financial Disclosure, if applicable

Every effort is made to insure that a prospective resident has the resources to live at Flushing House indefinitely. Therefore, we cannot make a final commitment until all of the financial information is submitted and has been reviewed. This normally can be accomplished in no more than a few days. If, in our estimation, your resources appear to be insufficient, we will require a Guarantor to assure payment of fees due under the Membership Agreement. Please be assured that all financial information submitted will be kept strictly confidential.

Once accepted, but before move-in, we will need the following:

  • Signed Flushing House Membership Agreement
  • Security Deposit (refundable only if notice is given 30 days prior to move out)
  • Entrance Fee ($1,000/studio, $1,500/suite)
  • First Month’s Service Fee

The Security Deposit will hold your apartment for up to five weeks. After that, if you have not moved in, the Monthly Service Fee stated in your Membership Agreement will be billed in order to continue to hold the apartment. If you withdraw your Application during the initial five week period, the Security Deposit will be refunded on a prorated basis. After the apartment is occupied, the Security Deposit will continue to be held until vacated. It will be refunded within 60 days of vacating the apartment, less any charges for repair and clean up, balances due, or any other charges payable in accordance with the Membership Agreement, as determined by Flushing House.

The Monthly Service Fee stated in your Membership Agreement represents a single, all-inclusive daily charge (covering room, two meals a day, weekly light housekeeping and linen service) which is payable on the first of each month, in advance. The Monthly Service Fee is reviewed and adjusted periodically, with changes effective on 30 days advance notice to you.

All of the information supplied for admission and financial purposes become a part of the Application. Any failure to disclose the Applicant’s financial condition fully and completely can result in termination of residency. Your signature on the Application authorizes Flushing House to verify any information presented.

Once again, we are delighted that you are considering joining the Flushing House family. If you ever have any questions, please do not hesitate to call us.

    FLUSHING HOUSE CLUB RESIDENCE APPLICATION FOR ADMISSION

    Full Name*
    Social Security Number*
    Street Address*
    Apt #
    City*
    State*
    Zip Code*
    Marital Status*
    MarriedSingle
    Email*
    Phone Number
    Date of Birth*
    Be placed on the FH Birthday List?*
    YesNo

    BILLING RESPONSIBILITY

    WHO WILL BE RESPONSIBLE FOR MONTHLY RENTAL CHARGES?
    ApplicantOther

    If Other, please complete section below

    Name
    Email
    Relationship
    Phone Number
    Power of Attorney?
    YesNo
    Guardian?
    YesNo
    Street Address
    Apt #
    City
    State
    Zip Code

    IN AN EMERGENCY, PLEASE NOTIFY

    Name
    Relationship
    Address
    Email
    Phone Number
    Name
    Relationship
    Address
    Email
    Phone Number
    Name
    Relationship
    Address
    Email
    Phone Number
    SEND THE FLUSHING HOUSE MONTHLY NEWSLETTER TO INDIVIDUALS LISTED ABOVE
    a $24 annual fee per person per issue mailed will be added to the bill, the newsletter is available at flushinghouse.com at no charge.
    YesNo

    FLUSHING HOUSE CLUB RESIDENCE FINANCIAL DISCLOSURE FORM

    All information stated will be kept strictly confidential

    Applicant

    Name*

    The following information is submitted to establish the financial ability of the applicant to reside at Flushing House. Any misrepresentation of resources can be grounds for termination of residency.

    If, in the opinion of Flushing House, there are not sufficient resources, a Guarantor may be required to guarantee payment of the account. The applicant’s signature authorizes the institutions listed to supply information necessary to make this determination.

    BANK ACCOUNTS

    Please include a copy of all statements, including Money Market, CD, and Investment Accounts

    Account #*
    Bank*
    Balance*
    Account #
    Bank
    Balance
    Account #
    Bank
    Balance
    Account #
    Bank
    Balance
    Account #
    Bank
    Balance
    Social Security Income (per month)*
    Pension Income (per month)*
    Investment Income (per month)*
    Other Income and/or Subsidy From Family Members (per month)*
    Assets (e.g., real estate, savings)*
    Liabilities (e.g., mortgage, medical bills, credit card, loans)*
    Recurring Expenses (insurance payments)*

    FLUSHING HOUSE CLUB RESIDENCE FINANCIAL DISCLOSURE FORM AND GUARANTEE

    All information stated will be kept strictly confidential

    Guarantor

    Name*
    Telephone*
    Street Address*
    Apt #
    City*
    State*
    Zip Code*
    Resident Name*
    Income From Employment (per year)*
    Income From Investments and Other Sources


    I understand that the above information, plus any attachments, is for the purpose of establishing my ability to serve as Guarantor on the account of the resident named above, and that misrepresentation of resources can be grounds for the termination of residency of the resident at Flushing House.

    To induce Flushing House to accept the resident named above, I hereby unconditionally guarantee the full and prompt payment of any and all amounts due and owing Flushing House by the Resident, and I shall promptly pay any such amount which is not paid by the resident for any reason. This is an absolute, unconditional, and unlimited guarantee of payment and may be proceeded upon by Flushing House before taking any action against the resident or after action against the resident has been commenced. My obligations hereunder shall not be discharged or impaired or otherwise affected by any waiver, modification, or amendment of any provision of the Resident’s Membership Agreement, by any default, failure or delay, willful or otherwise, in payment by Resident of any amount due by Resident to Flushing House, by any other act or thing or omission or delay to do any other act or thing which may or might in any manner or to any extent vary my risk or would otherwise operate as a discharge of me as a matter of law. This Guarantee will be governed by the laws of the State of New York.

    FLUSHING HOUSE CLUB RESIDENCE RESPONSIBLE PARTY’S PERSONAL AGREEMENT

    All information stated will be kept strictly confidential

    Responsible Party

    Name*
    Telephone*
    Street Address*
    Apt #
    City*
    State*
    Zip Code*
    Resident Name*

    I am the responsible party for the Resident named above. I attest that I have access to some or all of the Resident’s assets. I hereby agree to pay the cost of maintaining the Resident at Flushing House from the Resident’s own funds.

    At this point in time the Resident has a monthly income of $ with assets totaling $.

    Please check if you agree to all terms and conditions included in this form.
    Please check that all required fields are properly filled out before submitting the form.