1. Property Details
	Property Address:
	Postcode:
	Property Type:
	Please Select   Terraced Semi Detached Flat
	Furnished:
	YesNo
	Rent per month: £
	Deposit: £
	Rental period:
	Tenancy Start:
	< September 2010 > Mon Tue Wed Thu Fri Sat Sun 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 8 9 10
	No. of bedrooms:
	Please Select   Studio 1 Bedroom 1 or 2 Bedroom 2 Bedroom 2 or 3 Bedroom 3 Bedroom 3 or 4 Bedroom 4 Bedroom More than 4 Bedrooms

	2. Applicants Details
	Title:
	Please Select   Mr. Mrs. Miss Ms. Dr. Sir
	Gender:
	MaleFemale
	First Name(s):
	Surname:
	Maiden Name (if applicable):
	Date of Birth:
	< September 2010 > Mon Tue Wed Thu Fri Sat Sun 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 8 9 10
	No. of dependants:
	NI No:
	Home Tel. No:
	Mobile Tel. No:
	Current Address:
	Postcode:
	Period at Address:
	Date of Departure:
	< September 2010 > Mon Tue Wed Thu Fri Sat Sun 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 8 9 10
	Email Address:

	3. Regarding your Current Address
	I am currently:
	Please Select   a property owner. with parents. with relatives. with friends.
	Other:If other please provide further information
	Current Landlord (if applicable)
	Current Landlord:
	Address:
	Postcode:
	Phone No:
	Fax/e-mail:
	3.1 Previous Landlord/Letting Agent or Council if Council Tenant
	Name:
	Address:
	Postcode:
	Phone No:
	Fax/e-mail:

	4. Employment
	I am:
	Please Select   Retired Unemployed Student Employed full time Employed part time Starting new employment
	4.1 Current/New Employment Details
	Company Name:
	Commencement Date:
	< September 2010 > Mon Tue Wed Thu Fri Sat Sun 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 8 9 10
	Address:
	Postcode:
	Telephone No:
	Fax No:
	Job Title:
	Annual Salary: £
	Contact Name:
	Contact E-mail:
	Employment:
	Please Select   Temporary Permanent Contract
	Staff/Payroll No:

	5. Miscellaneous
	Do you have any pets?
	YesNo
	If so what pets do you have?
	Do you or any intended occupiers smoke?
	YesNo
	Please give full names, date of birth and occupation of all persons including yourself and any children who will occupy the premises.
	Names: Date of Birth: Occupation:
	Please state that the property you are applying for will be your principal home.
	YesNo