Tenant Registration Form

Please note that all fields are requested to be completed - If a field is not applicable write "N/A"  

Your Full Name *
Date of Birth *     
Current Address *
How Long at this address? *
Home Phone *
Mobile *
Email Address *
Reason for leaving this address? *
Current Landlord *
Current Landlord Phone *
Previous Rental Address *
Previous Landlord Name *
Previous Landlord Phone *
Your Occupation(s) *
Your Employer(s) *
Employer(s) Phone *
Partners Name *
Partners Occupation(s) *
Partners Employer(s) *
Partners Employer(s) Phone *
Who will be living with you (Names) *
How old are the children living with you? *
Pets (State Breed of Dog) *
Smokers? *Yes No


Drivers License *
Passport Number *
WINZ Number *
Car Registration *
Please supply the name, address and phone number of someone we can contact about your tenancy if for any reason we cannot contact you – i.e. parent, trustee or close relation.
Contact Person name & Phone *


Number of Bedrooms required *
Weekly Rent Sought $ *
Type of Dwelling *House Flat Garaging
Area Preferred *
Rental Term *Long Term Short Term
Preferred Start Date *   
Other Requirements *
NB. If you do not supply all information requested in this form you may not be considered for any rental properties available through Home Rental Services. 
Signed (Print Your Full Name) *
Date *   
I hereby confirm that the information contained in this form is true and correct and that I have read the Privacy Act Statement on the previous page.