Tenant Registration

Title:

First name:

Surname:

Date of birth:--

Gender:

National insurance number:

Current address:

Current address type:

Time at current address:

Previous address:

Time at previous address:

Reason for leaving:

Telephone:

Email:

Are you registered blind:YesNo

Landlord name:

Landlord address:

Landlord telephone:

Landlord Mobile:

Landlord Email:

Are you able to provide a landlord reference and / or a clear rent statement or alternatively allow us to contact your Landlord:YesNo

Do you have money available to pay for a months rent in advance:YesNo

Do you have money available to pay for a deposit / bond:YesNo

Property being applied for (if applicable):

Property post code (if known):

Length of tenancy required:

Required house type:

Number of bedrooms:

Maximum rent you can pay:£

Areas considered:

Do you require a furnished property:

Any special requirements: