Request a mutual exchange

Step 1 of 6

About you

Your Name(Required)

First Last

Your date of birth(Required)

Your address(Required)

Street Address Address Line 2 City Postcode

Your phone number:(Required)

Your email address:(Required)

Enter Email Confirm Email

Your National Insurance number:(Required)

Are you based in:(Required)

North area - Grimsby and surrounding areas

South area - Boston and surrounding areas

Do you have any mobility or medical needs?(Required)

Yes

Please give details of any mobility or medical needs:(Required)

Are you registered with Home Choice Lincs or Boston Home Choice?(Required)

Yes

Are you registered on www.homeswapper.co.uk(Required)

Yes

Your household

Please give details of all those who will be moving in with you:

Person 1 - Name

First Last

Date of birth

Person 2 - Name

First Last

Date of birth

Person 3 - Name

First Last

Date of birth

Person 4 - Name

First Last

Date of birth

Person 5 - Name

First Last

Date of birth

Do any members of the household have mobility or medical needs?(Required)

Yes

Please give details:(Required)