A1 Level 1 : Learning activity 3 : Stage 3

MOVING TO A NEW PLACE

Home
Tearch
application
Gorm
Please write the first or main applicants surname here
Important: Please make sure you read all the information presented in this document carefully before
you complete this form.

A. Your details
First name(s)
Give any other name(s)
you were previously known by
Date of birth
For example 06/12/1968
Current address
Postcode
Contact/correspondence
or safe address (if different
from above)
Contact telephone
numbers(s)
Email address

Servicio Nacional de Aprendizaje - SENA. Reservados todos los derechos 2013.

A1 Level 1 : Learning activity 3 : Stage 1

Do you experience difficulties

Yes

No

with reading or writing?

Whats your gender?
What is your religion?

Male

Female

Prefer not to say

Buddhist
Christian

Hindu
Jewish

Muslim Sikh

None

Other

(please specify)

B. Employment information
If you are working, please tell us:

Yes

No

What do you do?

C. Your family or household

We need to know if other people will be moving with you. This will help us to know what type of home
you will need. Please give their details below.
1st

2nd

3rd

Last name
First name
Date of birth
Gender
Relationship
to you (wife,
son, etc.)

Servicio Nacional de Aprendizaje - SENA. Reservados todos los derechos 2013.

A1 Level 1 : Learning activity 3 : Stage 1

D. Your present accommodation/circumstances

Tick the box against the property type in which you live or best describes your circumstances.

House

Trailer

Hostal

Flat/apartment

condominium

Hotel

Bungalow

Cottage

Terraced house

Detached house

Semi-detached house

No fixed address

E. Your house preferences

State your house preferences describing all the characteristics you want your new home to have.

House type (apartment, cottage, etc.)

Number of rooms
Number of bathrooms
Which floor (if located in a building)
Public utilities (gas, water, etc.)
Location
Price

Servicio Nacional de Aprendizaje - SENA. Reservados todos los derechos 2013.

A1 Level 1 : Learning activity 3 : Stage 1

F. Special requirements
Write a more detailed description of the kind of house you want to have.

G. Applicants signature
Name
Date

Servicio Nacional de Aprendizaje - SENA. Reservados todos los derechos 2013.