First Name:     Last Name:  
Phone Number:     Fax Number:  
Email Address:     Employer:  
Number of Occupants:     Pets:(What kind and size?)  
When are you needing an apartment?     Number of Bedrooms:  
How did you hear about us?     Please specify other here:  

How would you prefer us to contact you? E-mail
Fax
Phone
Mail
 
Notes:  


   

 Palm Chaparral
 38441 5th St. West
 Palmdale, CA 93551
 Phone: (661) 273-2677  Fax: (661) 273-8056
 Email: palmchaparral@amcllc.net
 Website: www.palmchaparralapts.com