Application Form

Please select lodge(s) according to your preference

1st Preference

2nd Preference (must not be the same as above)

3rd Preference (must not be the same as above)

4th Preference (must not be the same as above)

Number of applicants

Is this application for a single person or a couple?

Single

Couple

First Applicant Details

First Name

Family Name

Preferred name

Date of Birth

Name of emergency contact

Are you a Smoker?

Yes

Do you Vape?

Yes

Contact Number

Email Address

Occupation

Place of work

If studying, what and where are you studying?

Second Applicant Details

First Name

Family Name

Preferred name

Date of Birth

Name of emergency contact

Are you a Smoker?

Yes

Do you Vape?

Yes

Contact Number

Email Address

Occupation

Place of work

If studying, what and where are you studying?

Motor Vehicle

Do you have a motor vehicle?

Yes

What type of vehicle?

Car

Motorbike

Registration number

Further Information

When would you like to move in?

Please provide a statement about why you would like to live in one of our properties.

This is shared accommodation, please tell us a bit about yourself.

Do you need a WINZ form for bond/moving in costs?

Yes

Supporting documents (optional)

If you have any documents to support your application (such as ID) please upload here.

Choose File

Privacy Statement

The personal information collected on this form will be used to assess your potential suitability as a tenant at one of our lodges.

Providing some information is optional. If you choose not to enter details requested, it may affect your chances of being offered a room.

You have the right to ask for a copy of any personal information we hold about you, and to ask for it to be corrected if you think it is wrong.

If you’d like to ask for a copy of your information, or to have it corrected, please contact us at info@sharedliving.nz.

I have read and agree to the Privacy Policy above.

I acknowledge that all tenants of Shared Living NZ properties must be vaccinated against Covid-19.

Please review your application above before submitting.