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1. Home
2. Tenant Registration

Tenant Registration

First Name

Last Name

Username

Password

Photo (Optional)

Mailing Address

Email

Telephone

Month and Year of Lease Start Date

Register Date:

What is your Landlords Property Manager Number?

Select Property From your Landlord Property List:

 

array(20) {
  ["first_name"]=>
  object(stdClass)#12872 (5) {
    ["value"]=>
    string(7) "Premium"
    ["field_type"]=>
    string(4) "text"
    ["label"]=>
    string(10) "First Name"
    ["field_name"]=>
    string(10) "first_name"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(10) "first_name"
      ["label"]=>
      string(10) "First Name"
    }
  }
  ["last_name"]=>
  object(stdClass)#12871 (5) {
    ["value"]=>
    string(10) "Contractor"
    ["field_type"]=>
    string(4) "text"
    ["label"]=>
    string(9) "Last Name"
    ["field_name"]=>
    string(9) "last_name"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(9) "last_name"
      ["label"]=>
      string(9) "Last Name"
    }
  }
  ["nickname"]=>
  object(stdClass)#12870 (5) {
    ["value"]=>
    string(0) ""
    ["field_type"]=>
    string(4) "text"
    ["label"]=>
    string(8) "Nickname"
    ["field_name"]=>
    string(8) "nickname"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(8) "nickname"
      ["label"]=>
      string(8) "Nickname"
    }
  }
  ["input_box_1608993918"]=>
  object(stdClass)#12869 (5) {
    ["value"]=>
    string(18) "Premium Contractor"
    ["field_type"]=>
    string(4) "text"
    ["label"]=>
    string(12) "Company Name"
    ["field_name"]=>
    string(20) "input_box_1608993918"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(4) "text"
      ["label"]=>
      string(12) "Company Name"
    }
  }
  ["input_box_1621112888"]=>
  object(stdClass)#12868 (5) {
    ["value"]=>
    string(12) "202-222-0000"
    ["field_type"]=>
    string(4) "text"
    ["label"]=>
    string(12) "Phone Number"
    ["field_name"]=>
    string(20) "input_box_1621112888"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(4) "text"
      ["label"]=>
      string(12) "Phone Number"
    }
  }
  ["user_url"]=>
  object(stdClass)#12867 (5) {
    ["value"]=>
    string(19) "https://premium.com"
    ["field_type"]=>
    string(3) "url"
    ["label"]=>
    string(7) "Website"
    ["field_name"]=>
    string(8) "user_url"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(8) "user_url"
      ["label"]=>
      string(7) "Website"
    }
  }
  ["textarea_1608994146"]=>
  object(stdClass)#12866 (4) {
    ["value"]=>
    string(7) "Address"
    ["label"]=>
    string(8) "Textarea"
    ["field_name"]=>
    string(19) "textarea_1608994146"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(8) "textarea"
      ["label"]=>
      string(8) "Textarea"
    }
  }
  ["country_1608994099"]=>
  object(stdClass)#12865 (4) {
    ["value"]=>
    string(2) "US"
    ["label"]=>
    string(7) "Country"
    ["field_name"]=>
    string(18) "country_1608994099"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(7) "country"
      ["label"]=>
      string(7) "Country"
    }
  }
  ["user_email"]=>
  object(stdClass)#12864 (5) {
    ["value"]=>
    string(19) "testing@pcaclub.com"
    ["field_type"]=>
    string(5) "email"
    ["label"]=>
    string(13) "Contact Email"
    ["field_name"]=>
    string(10) "user_email"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(10) "user_email"
      ["label"]=>
      string(13) "Contact Email"
    }
  }
  ["user_login"]=>
  object(stdClass)#12863 (5) {
    ["value"]=>
    string(13) "premiumvendor"
    ["field_type"]=>
    string(4) "text"
    ["label"]=>
    string(17) "Create a Username"
    ["field_name"]=>
    string(10) "user_login"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(10) "user_login"
      ["label"]=>
      string(17) "Create a Username"
    }
  }
  ["user_pass"]=>
  object(stdClass)#12461 (5) {
    ["value"]=>
    string(9) "Premium22"
    ["field_type"]=>
    string(8) "password"
    ["label"]=>
    string(8) "Password"
    ["field_name"]=>
    string(9) "user_pass"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(9) "user_pass"
      ["label"]=>
      string(8) "Password"
    }
  }
  ["single_item_1609087193"]=>
  object(stdClass)#12460 (5) {
    ["value"]=>
    string(5) "75.00"
    ["field_type"]=>
    string(6) "hidden"
    ["label"]=>
    string(6) "hidden"
    ["field_name"]=>
    string(22) "single_item_1609087193"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(11) "single_item"
      ["label"]=>
      string(23) "Membership Fee $75/Year"
    }
  }
  ["check_box_1608994706"]=>
  object(stdClass)#12611 (5) {
    ["value"]=>
    string(314) "I agree: By submitting this form I agree to all the information provided above. I understand that PCA Club will verify all information listed, and contact me should they find anything that they are not able to verify that can cause a denial. I understand that my fee will be reimbursed if my application is denied."
    ["field_type"]=>
    string(8) "checkbox"
    ["label"]=>
    string(70) "Please check the box below to agree to PCA Club Application agreement."
    ["field_name"]=>
    string(20) "check_box_1608994706"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(8) "checkbox"
      ["label"]=>
      string(70) "Please check the box below to agree to PCA Club Application agreement."
    }
  }
  ["check_box_1608994245"]=>
  object(stdClass)#12610 (5) {
    ["value"]=>
    array(2) {
      [0]=>
      string(8) "Painting"
      [1]=>
      string(16) "Catering Service"
    }
    ["field_type"]=>
    string(8) "checkbox"
    ["label"]=>
    string(30) "What Home Industry are you in?"
    ["field_name"]=>
    string(20) "check_box_1608994245"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(8) "checkbox"
      ["label"]=>
      string(30) "What Home Industry are you in?"
    }
  }
  ["radio_1608994343118"]=>
  object(stdClass)#12609 (5) {
    ["value"]=>
    string(3) "Yes"
    ["field_type"]=>
    string(5) "radio"
    ["label"]=>
    string(49) "Do you have a license to work in your profession?"
    ["field_name"]=>
    string(19) "radio_1608994343118"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(5) "radio"
      ["label"]=>
      string(49) "Do you have a license to work in your profession?"
    }
  }
  ["radio_1608994432"]=>
  object(stdClass)#12607 (5) {
    ["value"]=>
    string(3) "Yes"
    ["field_type"]=>
    string(5) "radio"
    ["label"]=>
    string(64) "Are you willing to offer our clients 24 hour emergency services?"
    ["field_name"]=>
    string(16) "radio_1608994432"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(5) "radio"
      ["label"]=>
      string(64) "Are you willing to offer our clients 24 hour emergency services?"
    }
  }
  ["radio_1608994548"]=>
  object(stdClass)#12601 (5) {
    ["value"]=>
    string(3) "Yes"
    ["field_type"]=>
    string(5) "radio"
    ["label"]=>
    string(54) "Are you interested in PCA Club Direct pay for vendors?"
    ["field_name"]=>
    string(16) "radio_1608994548"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(5) "radio"
      ["label"]=>
      string(54) "Are you interested in PCA Club Direct pay for vendors?"
    }
  }
  ["radio_1608994185"]=>
  object(stdClass)#12600 (5) {
    ["value"]=>
    string(3) "Yes"
    ["field_type"]=>
    string(5) "radio"
    ["label"]=>
    string(49) "Do you carry insurance for your service/business?"
    ["field_name"]=>
    string(16) "radio_1608994185"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(5) "radio"
      ["label"]=>
      string(49) "Do you carry insurance for your service/business?"
    }
  }
  ["radio_1608994194"]=>
  object(stdClass)#12599 (5) {
    ["value"]=>
    string(8) "Email Me"
    ["field_type"]=>
    string(5) "radio"
    ["label"]=>
    string(48) "How would you prefer we contact you for services"
    ["field_name"]=>
    string(16) "radio_1608994194"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(5) "radio"
      ["label"]=>
      string(48) "How would you prefer we contact you for services"
    }
  }
  ["radio_1608994382"]=>
  object(stdClass)#12598 (5) {
    ["value"]=>
    string(3) "Yes"
    ["field_type"]=>
    string(5) "radio"
    ["label"]=>
    string(48) "Were you assisted by a PCA Representative today?"
    ["field_name"]=>
    string(16) "radio_1608994382"
    ["extra_params"]=>
    array(2) {
      ["field_key"]=>
      string(5) "radio"
      ["label"]=>
      string(48) "Were you assisted by a PCA Representative today?"
    }
  }
}