Apply for Senior Citizen Summer housing

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State

ZIP Code

Phone

Cell Phone

Email Address

Please list desired apartment(s) *Assignments are based on seniority

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Check box if its not okay for old farm to share your info with the USU S.C. Program

Rental Deposit

New Tenant – $300

Existing Tenant – $200

Check or Money Order

Send check or money order to:

Old Farm
777 East 1000 North
Logan , UT 84321