EmailMe Form - Application for Tenancy

EmailMeForm

Whats the address of the property your applying for? *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
About You
Title:
Mr
Miss
Ms
Mrs
Forename(s): *
Surname: *
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Years at address

(If you have lived at this address for less then 3 years, please complete the 'Previous Address' section below).
Email
Home Tel:
Work Tel:
Mobile:
Date Of Birth:
National Insurance No:
Current Occupancy Status:
Owner
Living with relatives
Private Tenant
Council Tenant
Current Marital Status:
Married
Divorced
Single
Separated
Widowed
Current Employment:
Employed
On contract
Retired
Student
Self Employed
Unemployed
Independent Means
If Employed:
Is your current post a permanent one? *
Yes
No
Is your employment to change in the near future? *
Yes
No
Please state the reason why you are moving:
Please give details of any adverse credit history:
Previous Address: *
Years lived at property:
Children -

(Please list anyone under the age of 18 who will be living with you)
How many adults (over the age of 18)?
Please list any specific requirements you may have.
Mailing List
This first section is for the applicants that wish to be placed on a mailing list. This means you are not applying for a specific property. If you have found a property that you wish to apply for, then please go to the next section "Housing Benefit".
Which areas are you looking for accommodation in?
How much rent do you want to pay?
Do you require
Furnished
Unfurnished
What size property do you require (e.g. number of bedrooms)?
Housing Benefit
Only prospective tenants intending to claim Housing Benefit, to pay either full or part of their rent, need complete this section.
Will you be claiming Housing Benefit?
Yes
No
Which benefits do you receive?
Address of the benefits agencys office handling you claim:
All tenants wishing to claim benefits are reminded that submitting a claim is no guarantee that your rent will be paid either in part of full. Should Housing Benefit not pay your full rent (as agreed in your tenancy agreement) YOU WILL HAVE TO PAY THE SHORTFALL. You should apply for a pre-tenancy determination by a rent officer if you are at all concerned.
Bank
Bank Name:
Address:
Postcode:
Account No:
Account name:
Sort Code:
Telephone No:
If you are self-employed, Please note that we will also require the name and address of your accountant.
References
Please give as many references as possible.
Current landlord
Name:
First Last
Address:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email:
Telephone No:
Personal Refernce
Name:
First Last
Address:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email:
Telephone No:
Next Of Kin
Name:
First Last
Address:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email:
Number:
Current Employer
Name: *
First Last
Address: *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Telephone No:
Position:
Gross Salary *
Start Date:
Previous Employer:
Name:
First Last
Address:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email:
Date Time:
DD / MM / YYYY
Self Employed
Please prvide Accountants Details Below
Name:
First Last
Email
Telephone No:
This next section is for Students
If you are not a student you do not need to complete this section of the form.
Student Number
University Address :

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
The date of which you need accomidation from:
MM / DD / YYYY
How will you be funded during the academic years?

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About You

If Employed:

Mailing List

Housing Benefit

Bank

References

Current landlord

Personal Refernce

Next Of Kin

Current Employer

Previous Employer:

Self Employed

This next section is for Students