Living space

When would you like to move in?

In what city or town are you looking for accommodation?

Surname:

Given name:

Day of birth:

Month:

Year:

Sex:

MaleFemale

Contact address:

Nationality:

E-mail:

Postcode:

City/town:

Mobile:

Telephone:

Second telephone number, e.g. parents:

Education:

Are you willing to share with another person?

YESNo

Employer:

Do you have any pets?

YESNo

What prompted you to look for accommodation through DEX? :

What do you expect from us? *

How did you hear about us? :

Comments:

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