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
Date
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
Date
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?*

YesNo
If you have been declared bankrupt indicate date..

DayMonthYear
Date
Preferred Property Location Criteria*

Ballymena Business Centre: Town Centre - Office, Retail Arts and CraftsBallymena Business Centre: Galgorm - Business to Business inc. manufacturing, production, engineering, product development, professional services, trade services. Retail is not permitted.Ballykeel Business Centre: Ballykeel - Community Based BusinessesBallee and Harryville Business Centre - Community Based Businesses
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*

Clear
Date*

DayMonthYear
Date
Should be Empty: