Helpful Housemate Application Form

Helpful Housemate Application Form
Full Name
Date of Birth

DayMonthYear
Date
Address

Street Address

Street Address Line 2

CityCounty

Post Code
Email
example@example.com
Phone Number

Phone Number
Nationality
Languages spoken?
Do you smoke or vape?

YesNo
Would you live with a pet?
Do you have a pet to bring?
If you do have a pet, please advise what kind of pet it is and what happens to it when you are not at home. Please note most Hosts can not accommodate pets.
When are you available to move?

DayMonthYear
Date
Occupation

WorkingStudyingBothOther
When would you be able to offer the help?
Short biography/introduction to yourself - Include information about your work/study, your hobbies and interests, why you are interested in this scheme and any experience you may have with helping others.
What length of time do you need this accommodation for?

6 months6-12 monthsOver 12 months
Do you smoke?
Location of accommodation interested in?
Have you ever been evicted from any accommodation arrangement?
If yes, please give full details.
Are you aware of anything that may affect your credit rating?*

YesNo
If your credit rating may be affected, please give full details.
Take Photo of you for your application.
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Signature
Assigned to
Client Type
Type
Date

DayMonthYear
Date
Should be Empty: