Housing Request

All fields marked with ** must be completed
First Name : **
Family Name : **
Your E-mail : **
Telephone N° : **
Fax N°:
Current Address:

Nationality:		1st language:
Name of Partner:		Nationality:
Name of Child (1):		Date of Birth Child (1):
Name of Child (2)		Date of Birth Child (2):

Employer's Details :
Name of Your Employer:
Employers' Address:
Company Telephone No:
Company Fax No:
Expected Transfer Date:
Length of Stay:

Type of Accommodation required :
Type	Apartment House	N° of Bedroom(s)	Studio 1 bedroom 2 bedrooms 3 bedrooms 4 bedrooms 5 bedrooms
Furnished	Yes No	N° of Bathroom(s)	1 bathroom 2 bathrooms 3 bathrooms
Rent	Buy	Location:	City Centre Suburb No matter
Please rate the importance of the following according to the scale : 1- Very important 2- Flexible 3- Not necessary
Closed Garage	1 2 3	Balcony/Terrace	1 2 3
Parking Space	1 2 3	Elevator	1 2 3
Garden	1 2 3	Fireplace	1 2 3
Will you bring a car with you?	Yes No	2nd car?	Yes No

Maximum Preferred Driving Time from your place of Employment:
15 min 30 min 45 min 1 hour no matter
Do you have pets? Yes No	If yes then please specify:
Leasing Contract Paid by:	Budget:
Contact Person:	Tel:
Comments:
By submitting this form it is understood that Integreat will provide a pre-selection of available housing options most suitable to the criteria mentioned above, and based on the current local market. Once a selection is made, all necessary costs affiliated with the move, i.e. agency fees, removal companies, etc., will be at my own responsibility. Integreat will invoice for their services only.