Property Application Form

Property Application Form

Ballymena Business Centre
Name

First NameLast Name
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
If you have not lived at this address for more than 3 years please provide previous address below....
Date of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
National Insurance Number
Business Name
Business Address [if you are currently renting property]

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
Telephone / Mobile
Website / Social Media
Business Sector
Business Status
Company Registration Number / Charity Number [if applicable]
Date You Started in Business or Propose to Start in Business

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Annual Turnover Band
Describe your business activity including product / service details and business activity you propose to deliver from property.
maximum 100 words
What are the key areas of focus for your business in the next 3 years?
maximum 100 words
Reference One [if you are in business please provide a business reference]
Name of Person
Business / Personal Relationship
Accountant, Supplier, Minister, Doctor
Contact Telephone Number
Contact Email Address
Reference Two [if you are in business please provide a business reference]
Name of Person
Business / Personal Relationship
Accountant, Supplier, Minister, Doctor
Contact Telephone Number
Contact Email Address
Have you ever been declared bankrupt?
If you have been declared bankrupt indicate date..

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Preferred Property Location Criteria
Please describe your business meets the above Location Criteria
Declaration

I understand that all the information provided in this application is correct and will be used by Ballymena Business Centre to assess my suitability for rental of workspace managed by the Centre.

I understand and give permission for Ballymena Business Centre at their own discression credit checks and obtain references from the contacts provided.

I undertand that this is not a legally binding document and does not entitle me to rental of property managed by Ballymena Business Centre.
Signature
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Should be Empty: