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  1. Must be within the city limits of the City of Michigan City.
  2. Primary Phone Type*
  3. Please indicate the date of your departure and the date of your return.
  4. Does your home have automatic lights?*
  5. Please indicate an additional person with access to your home.
  6. Keyholder's Phone Type
  7. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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  9. This field is not part of the form submission.