Application Form – Sirovilla

Location*

Are you applying for a 1 bedroom or 2 bedroom unit?*

1 bedroom

2 bedroom

Application details

Name*

Address*

Street Address Address Line 2 City State Post code

Date of Birth*

Mobile number **

Phone number

Pension No (CRN)

Email address*

APPLICANT no.2

Please fill in the below details if your application is for a 2 bedroom unit.

Name

Address

Date of Birth*

Phone

Mobile number

Pension No (CRN)

Email address

Emergency contact

Name*

Email address*

Address*

Street Address Address Line 2 City State Post code

Mobile number*

Relationship*

Current circumtances

Please describe your current housing situation*

Current renting

Home owner

If renting - how much are you currently paying per week*

If renting – Do you have a lease in place, if so for how long*

Financial information

Before an offer is made you will be required to provide a current income statement on your household’s income.

Assets

Are you currently receiving a Centrelink income ?*

Yes

If not, will you be eligible for the Aged Pension ?*

Yes

Do you own (or part own) a residential property?*

Yes

Do you have assets that give you an income?*

Yes

If yes, please state your gross household fortnightly income*

Does your household have a total of more than $30,000 (This includes savings, superannuation, investments, shares)*

Yes

Please tell us about your links to the area/s (Highton, Anglesea, Point Lonsdale)

This can include links such as family, friends, or if you have lived in the area in the past.

Fact sheet

I confirm I have received a Factsheet.*

Yes

Please download the below fact sheet and read it in order to proceed. You can update your answer in the above field once you have read this fact sheet.

View Anglease Fact Sheet

Please download the below fact sheet and read it in order to proceed. You can update your answer in the above field once you have read this fact sheet.

View Highton Fact Sheet

Please download the below fact sheet and read it in order to proceed. You can update your answer in the above field once you have read this fact sheet.

View Point Lonsdale Fact Sheet

You can also view our FAQ page.

Privacy Statement I consent to the information contained within this application being collected, used and disclosed by Sirovilla solely for purposes outlined in the Sirovilla Privacy Policy and that I can access the Sirovilla Privacy Policy at the Sirovilla Office. I understand that I can request to view any information supplied by me and held by Sirovilla.

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