Rental Application Form

Name *

First Name

Last Name

Phone *

Country

(###)

###

####

Preferred Length of Tenancy *

6 months (i.e 26 weeks)

Under 12 months

12 months (i.e. 52 weeks)

More than 12 months

Any

Preferred Commencement Date *

MM

DD

YYYY

Have you rented in Canberra before? *

Yes

No