rent a room in wrexham

Name *

First

Middle

Last

Email *

Email

Confirm Email

Phone Number *

Date of Birth *

Nationality *

National Insurance Number *

ie NX 34 67 78 D

Current living address (FULL Postal Address required) *

If less than 3 years living at this address please provide previous address in next box

Time started living at that address? (year and month) *

Previous address (FULL postal address)

If living at your current address LESS than 3 years please provide previous address here

Time started living at that address? (year and month)

At this property i was *

If renting please provide current /previous Landlords name and contact details;

Have you got any oustanding rent arrears or County Court Judgements in your name in the past 6 years? *

Employment Status *

Which place do you work or study? (enter more than one answer if both or more than one job) *

Your Facebook page link

WhatsApp phone number (if different from above Phone number)