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A1 Level 1 : Learning activity 3 : Stage 1F.Special requirements
MOVING TO A NEW PLACE Home Tearch application Gorm
Please write the first or main applicants surname hereTorres
Important: Please make sure you read all the information presented in this document carefully before you complete this form.
A. Your details
First name(s)Zulma
Give any other name(s)
you were previously known by
Date of birth02/09/1991
For example 06/12/1968Calle 11 #5-123
Current address540006
PostcodeContact/correspondenceAvenida 1 #11-156
or safe address (if different from above)3013458723
Contact telephone numbers(s)[email protected]
A1 Level 1 : Learning activity 3 : Stage 31
Email addressServicio Nacional de Aprendizaje - SENA. Reservados todos los derechos 2013.
A1 Level 1 : Learning activity 3 : Stage 1
Do you experience difficulties with reading or writing?
Whats your gender?
Yes
Male
No X
Female XX
What is your religion?
Prefer not to say
Muslim Sikh
BuddhistChristian
None
HinduJewish
Other(please specify)
B. Employment informationI am a engineer
If you are working, please tell us:
What do you do?
Yes X No
C. Your family or household
We need to know if other people will be moving with you. This will help us to know what type of home you will need. Please give their details below.
1st2nd3rd
Last nameTorresVelsquez
First nameJuly
Date of birth23/11/1989
GenderFemale
Relationship to you (wife,son, etc.)
Sister
D. Your present accommodation/circumstances
Tick the box against the property type in which you live or best describes your circumstances.
HouseXTrailerHostal
Flat/apartment
condominiumHotel
BungalowCottageTerraced house
Detached houseXSemi-detached houseNo fixed address
E. Your house preferences
State your house preferences describing all the characteristics you want your new home to have.
House type (apartment, cottage, etc.) Number of roomsNumber of bathrooms
Which floor (if located in a building) Public utilities (gas, water, etc.) LocationPrice
Write a more detailed description of the kind of house you want to have.
I want something very confortable, its in a tranquil zone and small but cozy
G. Applicants signature
NameZulma torres Velsquez
Date01/04/2014Servicio Nacional de Aprendizaje - SENA. Reservados todos los derechos 2013.