| First Name: |
| Last Name:
|
| Sex:
|
| Your Age |
| Are you a smoker?
|
| Country:
|
| What type of visa do you hold? |
| other:
|
| I'm interested in the guest house(first choise) |
| I'm interested in the guest house(second choise) |
| Your budget \ |
| Your priority is:
budget
location
condition |
| Date you plan to move in: , |
| Will stay for at least:
month(s) |
| Contact Phone Number (optional): |
| Email Address (required): |
| Where did you come from (required):
|
Ｐｌｅａｓｅ ｂｒｉｅｆｌｙ ｅｘｐｌａｉｎ ａｂｏｕｔ ｙｏｕｒｓｅｌｆ：
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