Date:  ....................................

Name:  ...........................................................................................................

Address: .........................................................................................................
[current]
  .....................................................................................................................

  .....................................................................................................................

Telephone: (Home)  .....................................     (Work)...................................



Looking for: House   Bungalow  Flat   Room    Other     ..................................

Furnished  or  Unfurnished

No of bedrooms reqd.:   ................

Max affordable rent:      £ ..............

Area / town:  ................................................


Requirements:

Children  (please detail ages)   ..............................

Garage required / preferred / not required 
   
Smokers   Yes  /  No

Garden  required / preferred / not required

Pets  Yes  /  No

Length of tenancy: 6 months  /  12 months  /  Other       ...............

Income details:

Working  /  Private funds  /  Retired  /  DSS  /  Other: ...................