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Your Job Title

Company Name

Your Name*

Your Last Name*

Company Address

Building Number/Street*



Post Code*


Phone Number*


About the Applicant

Applicants First Name*

Applicants Last Name*

What is the applicants job title?

Is the applicant a current or previous employee?

What is the applicants current/previous salary?

Is/was the applicant on a permanent or temporary contract?

If temporary, when is it due to end?

Is the applicant currently on notice to leave the company?

Do you believe the applicant would make a good tenant?

Please provide any additional information that you feel would support our descision in housing the applcant

Thank you very much for providing this information to us, please be assured that the information contained in this form will be handled with confidence and will not be disclosed to the applicant.

Enter the characters as they are shown*