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First Name

Last Name

Gender
malefemale

Email

Phone Number

Age

Occupation

Ethnicity (optional)

Languages spoken in addition to English

Address

Postcode

How many other people live in the house?
I live alone1 more person2 more people3 more people4 more people5 or more people

How long does it take to walk from your house to the nearest bus/tram stop?

I live in
A houseA flat

How many rooms do you have available to rent out to students?

Room Types
SingleDoubleTwinEn-suite

Is there a desk in the room?
yesno

Do you have wireless internet?
yesno

How many bathrooms are there in the house?

Is there a smoke alarm?
yesno

Do you have housing insurance?
yesno

Do you have an pets?
yesno

Can you show us an up-to-date gas safety certificate
yesno

Do you or other people smoke?
Yes, in the houseYes, in the gardenNo, nobody smokes at all

Our student can smoke:
In the houseIn the gardenSmoking not allowed at all

Can you provide laundry service or give access to a washing machine?
YesNo

Can you cater for a special diet?
YesNo

I can host:
Male students onlyFemale students onlyBoth male & female

I can host:
Students 16 years old and olderStudents 18 years old and older

I have an up-to-date DBS - criminal record check (not older than 2 years)
YesNo