Application for Tenancy (Step 1 of 3)

First Applicant's Details

Full Name:

Date of Birth: 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990

Telephone (Home):	Telephone (Work):
Telephone (Mobile):	Email Address:

Current Address

Address:

Rent per Week $	How long did you live there?
Agent/Landlord	Telephone
Why did you leave?

Employment

Current Employer:

Address:

Your Occupation:

Weekly Wage: $

Period of Employment:

Telephone (Work):

Personal Details

Medicare Card:
Drivers Licence:	Expiry Date of Licence:
Passport Number:	Expiry Date of Passport:

Occupancy Details

Total number of Occupants who will live in this property:
Number of children (if any):	Age of Children:
Pets? Yes No	No. of Pets & Type:

Emergency Contact Details

Full Name:	Relationship:
Address:
Telephone (Home):	Telephone (Work):

Personal References (not relatives)

Name	Address	Telephone (Home)
1.
2.

Next of Kin

Name	Address	Telephone (Home)
1.
2.