Short Term Rent Request Form

* Name

* Email

* Phone

Skype (if available)

* Your current location (please specify country and city)

* If not currently in Ukraine, when you plan to be in Kiev to see suggested apartments and possibly sign the lease (please specify year, month and possible dates)?

* Expected Lease Starting Date

* Expected Duration of Lease

* Total number of tenants (select) 1 2 3 4 5 6 7 8

* Number of children (select) None 1 2 3 4 5 6 7

Age of Children

* Tenants' citizenship

Type of visit

Any pets?

* Select Place or District (select) Downtown Academmistechko Berezniaki Bilychi Borshagivka Bortnychi Bykivnia Chapaivka Chokolivka Darnytsky Demiivka Desniansky Dniprovsky Holoseevsky Holosiivo Holosiivski (Center) Holosiivsky District Kadetsky Hay Karavaivi Dachi Kharkivsky Massiv Kharkovsky Komsomolsky Massiv Korchuvate Kotsiybynske Kreshatik Kurenivka Lipki Lisovy Liviberezhny Massiv Lukianivka Lukyanovka Minsky Massiv Mostytsky Mykilska Slobidka Nova Darnytsia Novobilychi Nyvky Nyzhni Sady Obolobsky Obolon Osokorky Pechersk Pechersky Pechersky (Center) Pershotravnevy Podil Podilsky Podyl Pozniaky Ppozniaki Pusha-Vodytsia Raiduzhny Rusanivka Rusanovka RVRZ Saperna Slobidka Shevchenkivsky Shevchenkivsky (Center) Shevchenkivsky (KPI) Shuliavka Solomianka Solomiansky Sotsmistechko Stara Darnytsia Sviatoshinsky Sviatoshyn Sviatoshynsky Syrets Tatarka Teremky-1 Teremky-2 Troeshina Troishyna Vetriani Hory Vidradny Vinogradar Voskresenka Zhuliany Zvirynets (other)

If Other

How far from Subway Does not matter 1/2 km 1-3 km

Left or Right bank Does not matter Left bank Right bank

* Total number of rooms, besides kitchen (including bedrooms, living room, study room) (select) 1 2 3 4

Total size of apt. (sq. meters) (select) <30 30-50 50-70 70-100 >100

Building type Does not matter Old historical Standard Soviet-style Modern

Floor Does not matter Ground Upper Middle

Condition of the apartment and decoration

Furniture (list what should be included in any case)

TV Does not matter Preferable Ultimately Required

Satellite Does not matter Preferable Ultimately Required

Cable Does not matter Preferable Ultimately Required

DVD, Home theater Does not matter Preferable Ultimately Required

Internet Does not matter Preferable Ultimately Required

Telephone Does not matter Preferable Ultimately Required

Washing machine Does not matter Preferable Ultimately Required

Dryer Does not matter Preferable Ultimately Required

Microwave Does not matter Preferable Ultimately Required

Dishwasher Does not matter Preferable Ultimately Required

Short-term (per day) <$60 $60-$100 $100-$150 $150-$200 $200-$300 >$300