EASY MOVE REQUEST FORM
About your household
Head of household:
___________________________________________
Date of birth:
___________________________________________
Contact telephone number: ______________________________________
Household member 1 ___________________________________________
Relationship to head of household _________________________________
Date of birth
__________________________________________________
Household member 2 ____________________________________________
Relationship to head of household __________________________________
Date of birth
__________________________________________________
Household member 3 ____________________________________________
Relationship to head of household __________________________________
Date of birth
__________________________________________________
About your current property
Address_______________________________________________________
Property type (Please circle)
House
No. of bedrooms (Please circle)
Bungalow
1
2
Flat
3
4
Bungalow
Flat
5+
What would you like?
Property type (Please circle all that apply) House
Would you accept sheltered accommodation?
Yes
Bedsit
No
Please list all towns, villages & streets where you would consider moving to:
______________________________________________________________
______________________________________________________________
Please list all towns, villages & streets where you would NOT consider moving to:
______________________________________________________________
_______________________________________________________________
Signed: ___________________________ Date: _______________________
Please return this form to: Property Marketing, Roddons Housing Association,
Beacon House, 23 Hostmoor Avenue, March, PE15 0AX
(Version 1 170709)