Extended Stay Application

For extended stay, fill in the Application form below. Following successful completion of necessary credit and reference checks, we will contact you and arrange your moving in date/time.

If you are human, leave this field blank.

Full Name *

Email *

Phone *

Date of Birth *

e.g. 01/01/2000

Occupation

Emergency Contact

Employment And Income

Click if Not Currently Working

Not Currently Working

Employer Name

Employer Contact Details - Email / Phone:

Length of Employment

Weekly Income (after tax)

Rental History

Current/Previous Landlord Name

Landlord Contact Number

Length of Tenancy

Reason for Leaving

Have you ever been evicted ? *

Yes

No

Have you ever broken a tenancy agreement? *

Yes

No

if Yes, please explain

Referees

Personal Reference Name 1

Relationship 1

Contact Phone 1

Personal Reference Name 2

Relationship 2

Contact Phone 2

Additional Information

Motel Unit / Cabin or Site Number

Move in date requested *

Number of occupants who will live/stay *

Do you have pets? *

Yes

No

If yes, please describe Pets

Do you smoke ? *

Yes

No

Do you consent to a background check ? *

Yes

No

Do you consent to a credit check ? *

Yes

No

Declaration and Signature

I certify that the information provided above is true and accurate to the best of my knowledge. *

I authorise YourRentalManager Limited to contact the references provided and to conduct credit and background checks where applicable.

Signature

Reset Signature

Today's Code *

today's code = 2919389

Submit Your Application