Naakantie 2 A, 48230 Kotka
Tel. (05) 225 5600, fax (05) 225 5660
Internet www.kotopas.fi

NOTE! Appendices must be delivered by ordinary post or telefax!

* fields marked with asterisk must be completed An insufficiently completed application is not processed!	NEW APPLICANT   FORMER TENANT   CHANGE OF FLAT
A APPLICANT'S PERSONAL DETAILS
Last name *
First name *
Personal identity number*	/Date of birth
Sex *	FEMALE          MALE
Street address *
Post office and post code *
Nationality
Telephone number *
E-mail address
Accommodation offer	by post    by email
B APPLICANT'S SCHOOL INFORMATION
School/studies/job/other *
Starting month and year of studies *
Estimated graduation
C PERSONS MOVING WITH THE TENANT
Name of spouse
Personal identity number of spouse	/Date of birth
Telephone number
E-mail address of spouse
School/studies/job/other
Estimated graduation
D Children (itemise only if child(ren) move with parent(s))
Name and personal identity number	/Date of birth
Name and personal identity number	/Date of birth
E NEED FOR THE APARTMENT (dd.mm.yy)
For the time being, starting from *
During period
Further information
F WISH FOR THE APARTMENT
Wish for certain apartment, look for list	1. (code)   2. (code) 3. (code)   4.  any apartment
Internet connection	yes.      no
Basic furniture	yes    no
Other special requests
G Please, notify approval to the address (if different than above)
Address
begin/during
	NOTE! When you have sent the application form, you will be automatically redirected to 'Thank you'-page. It means that your application has been sent to us. You do not have to confirm the sending by phone.