Salutation

Firts name

Mr.     Mrs.

Surname

Current residence

E-mail

Phone number

Type of employment

NET income per month

Amount of children (18 -)

Amount of adults (18 +)

Pets

Kind of pet and number

Yes     No

Preferred first rental day

Maximum rental price

Preferred appointment day

Which part of the day

09-13.00     16-19.00

Reference number(s) of the house(s) to be visited