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Servicio Nacional de Aprendizaje - SENA. Reservados todos los
derechos 2013.
A1 Level 1 : Learning activity 3 : Stage 1 A1 Level 1 : Learning
activity 3 : Stage 3
MOVING TO A NEW PLACEHomeTearchapplicationGorm
Please write the first or main applicants surname here
Important: Please make sure you read all the information
presented in this document carefully before you complete this
form.
First name(s)
Give any other name(s)
you were previously known by
Date of birth
For example 06/12/1968
Current address
Postcode
Contact/correspondence
or safe address (if different
from above)
Contact telephone
numbers(s)
Email address
A. Your details
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Servicio 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?
What is your religion?
Yes
Yes
Male
Prefer not to say
Muslim Sikh
Buddhist Christian
None
Hindu Jewish
Other(please specify)
No
No
Female
B. Employment information
C. Your family or household
If you are working, please tell us:
What do you do?
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.
1st 2nd 3rd
Last name
First name
Date of birth
Gender
Relationship
to you (wife, son, etc.)
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Servicio Nacional de Aprendizaje - SENA. Reservados todos los
derechos 2013.
A1 Level 1 : Learning activity 3 : Stage 1
D. Your present accommodation/circumstances
E. Your house preferences
Tick the box against the property type in which you live or best
describes your circumstances.
State your house preferences describing all the characteristics
you want your new home to have.
House Trailer Hostal
Flat/apartment condominium Hotel
Bungalow Cottage Terraced house
Detached house Semi-detached house No fixed address
House type (apartment, cottage, etc.)
Number of rooms
Number of bathrooms
Which floor (if located in a building)
Public utilities (gas, water, etc.)
Location
Price
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Servicio Nacional de Aprendizaje - SENA. Reservados todos los
derechos 2013.
A1 Level 1 : Learning activity 3 : Stage 1
F. Special requirementsWrite a more detailed description of the
kind of house you want to have.
G. Applicants signatureName
Date
C1: MURCIANAME: RICARDONAME2: BIRTH: 31/05/1996ADDRESS: CLL 12
N6-73POSTCODE: Y1: N1: xMALE: xFEMALE: R1: xR2: R3: R4: R5: R6: Y2:
N2: xOCUPATION: I am student11: OSPINA12: GLADYS13: 09/09/196514:
FEMALE15: MOTHER25: BROTHER21: MURCIA22: CRISTIAN23: 30/06/199824:
MALE31: ROJAS32: GILMA33: 09/08/194034: FEMALE35: GRANDMOTHERHOUSE:
TRAILER: HOSTAL: FLAT: XCONDO: HOTEL: BUNG: COTTAGE: TERRACED:
DETACHED: SEMI-DETACHED: NOFIXED: HOUSETYPE: APARTMENTNOROOMS: 4
NOBATH: 4NOFLOOR: SECONDPUBLIC: GAS, WATER AND LIGHTLOCATION:
DOWNTOWNPRICE: ONE HUNDRED MILLION PEOPLESPECIAL: I want to have a
big and comfortable apartment, with a spacious balcony, large and
furnished bedrooms and finally with a wonderful parking space in
the building and excelent stairs and elevators.GNAME: Ricardo
Murcia OspinaGDATE: 03/04/2015CONTACT: TELEPHONE: 3104595006EMAIL:
[email protected]
