Authorised Service Centre

47a Eaglehawk Rd, Bendigo VIC 3550
(Opposite Fruit Shack next to SuperPower)
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Phone 5442 7000

 

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Proposed Renter Details


APPLICATION TO RENT

To start the rental process please fill in the form below and click on submit to send to our rental department for processing.  A member of our rental department will contact you when completed.

Proposed Renter Details

Full Name
Date of Birth
Address
Phone Number
How long this address
Previous Address
Mobile Phone No
How long this address
Occupation
Licence Number
Car Rego Number
Employer
Phone Number
How long Employed
Landlord
Phone Number
 
Applicants Parents Name & Address
Phone Number

References

Name
Address
Phone Number
Relationship
Name
Address
Phone Number
Relationship
Name
Address
Phone Number
Relationship
Name
Address
Phone Number
Relationship

Please list what equipment are you wish to rent:

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