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A1 Level 1 : Learning activity 3 : Stage 3

MOVING TO A NEW PLACE


HomeTearchapplicationGorm
Please write the first or main applicants surname here

PERDOMO

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)

Lina

Give any other name(s)

Paola

you were previously known by

07/10/1991

Date of birth
For example 06/12/1968
Current address

46 Street # 16 - 224

Postcode

051022

Contact/correspondence
or safe address (if different
from above)
Contact telephone

3165000

numbers(s)
Email address

linap.geo09@gmail.com

Servicio Nacional de Aprendizaje - SENA. Reservados todos los derechos 2013.

A1 Level 1 : Learning activity 3 : Stage 1

Do you experience difficulties

Yes

No

Female

with reading or writing?


Whats your gender?
What is your religion?

Male
Prefer not to say

Buddhist
Christian

Muslim Sikh

None

Hindu
Jewish
Other

(please specify)

B. Employment information
If you are working, please tell us:

Yes

No

What do you do?

I am Geologist

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.
1st

2nd

3rd

Last name

Perdomo

Tovar

Perdomo

First name

Gabriel

Maria Eugenia

Natalia

Date of birth

16/10/1959

27/06/1966

14/10/1998

Gender

Male

Female

Female

Relationship

Father

Mother

Sister

to you (wife,
son, etc.)

Servicio Nacional de Aprendizaje - SENA. Reservados todos los derechos 2013.

A1 Level 1 : Learning activity 3 : Stage 1

D. Your present accommodation/circumstances


Tick the box against the property type in which you live or best describes your circumstances.

House

Trailer

Hostal

Flat/apartment

condominium

Hotel

Bungalow

Cottage

Terraced house
X

Detached house

Semi-detached house

No 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.)

Cottage

Number of rooms

Number of bathrooms

Which floor (if located in a building)


Public utilities (gas, water, etc.)

electricity, natural gas, water, telephone

Location

Suburb

Price

$ 1'500.000 - $ 2'000.000 month

Servicio Nacional de Aprendizaje - SENA. Reservados todos los derechos 2013.

A1 Level 1 : Learning activity 3 : Stage 1

F. Special requirements
Write a more detailed description of the kind of house you want to have.

Backyard, garden front of house, two garages, one or two floor house, waste disposal.

G. Applicants signature
Name

Lina Paola Perdomo Tovar

Date

08/08/2015

Servicio Nacional de Aprendizaje - SENA. Reservados todos los derechos 2013.

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