Share |
 
  Apply for Maple Crest Residency
Name(s)*  
Address
Street*
 
City*
 
State*
 
Zip*
 
Telephone
Email
username@domain.com
Contact Person*  
Relationship
Address
Street*
 
City*
 
State*
 
Zip*
 
Telephone*  

Housing Interest
Duplex Home    Congregate Apartment    Assisted Living Residence
Style A
Style B
Style C
Style D
One-Bedroom
One-Bedroom with Den
Two-Bedroom
Garage
Efficiency
Efficiency with kitchenette
One-Bedroom
Garage

I/We are interested in a home at Maple Crest Senior Living Village. I/We have completed this reservation form and are submitting it to Maple Crest of Mennonite Memorial Home. I/We understand a fee of $25.00 is requested to follow this application through the mail to reserve a place on the waiting list. I understand that at the point that I/We reserve a specific unit at Maple Crest that a deposit of $1500 will be required. These fees are non-refundable but will be applied to the Life Use payment or held as a rental deposit when the Residency Agreement is signed.

Write check to:
Maple Crest of Mennonite Memorial Home
Attention: Admissions
700 Maple Crest Court
Bluffton, Ohio 45817

* required fields