Accommodation application

Otaika Accommodation Park is a community-based accommodation environment. All residents are expected to behave respectfully towards neighbours, staff, contractors, and visitors. Violent, threatening, intimidating, or illegal behaviour may result in termination of occupancy.

Applicant detailsFull name *Date of birth Phone number *Email address *Current address

Emergency contactName Relationship Phone number

Accommodation requirementsNumber of occupants (including yourself) Names of other occupants Preferred move-in date

Employment & incomeIncome sourceEmployer (if applicable) Weekly income (approx.)

Vehicle detailsDo you have a vehicle?

References

Previous landlord / accommodation provider

Name Phone

Important questionsDo you have any support needs we should be aware of to help ensure your accommodation is suitable?Are there any health, mobility, or support requirements that may affect your ability to live independently?Is there anything we should know to help maintain a safe and respectful living environment for all residents?Have you ever been subject to a Trespass Notice from previous accommodation providers? If yes, please give details.Have you ever been evicted from accommodation? If yes, please provide details.Have you ever been asked to leave accommodation before? If yes, please explain.

Please note: we do not allow pets.

DeclarationI can comply with the park rules and expectations regarding behaviour, visitors, noise, and respect for other residents. *I declare that the information provided is true and correct. I understand that providing false information may affect my application. *