Staff room registration form

- Bern

PLEASE FILL IN ON THE COMPUTER.

1. Person	2. Person (additional for double room)
Last name
First name
Date of birth
Nationality
Identity card B / C
Marital status
Corresp. language	☐ German ☐ English	☐ German ☐ English
Current address
Current landlord
Can we make inquiries with your current landlord/employer?
☐ yes ☐ no	☐ yes ☐ no
Mobile phone
Business phone
Private E-Mail
Occupation
Move-in date (desired)	1st / 16th every month	1st / 16th every month
Move-out date (desired)	15th / 31st every month	15th / 31st every month
Place of work Inselspital
Internal phone
Start of job

Necessary enclosures:

Copy of personal identity card or foreigner's identity card (passport, ID, residence permit)

For employees of the Insel Gruppe: Confirmation from employer regarding duration of employment

Staff room registration form

- Additional sheet for different invoice recipient

Please enter the address data for the invoice recipient below if this is not the same as the rental contract person.

Invoice recipient	1. Person	2. Person (additional for double room)
Firm
Last name
First name
Corresp. language	☐ German ☐ English	☐ German ☐ English
Current address
Mobile phone
Business phone
Private E-Mail

STAFF ROOMS (rented primarily to employees of the Insel Group)
Important:	- The rent includes service charges. - The minimum rental period is 1 month. - Fixed-term rental contracts can't be terminated before the end of the agreed rental period. - Subtenants and guests as well as pets and making music aren't allowed in staff rooms.

Please tick the desired offer.	Valid from 01.11.2023 Rent per month / staff room Internal staff (External tenants)
☐	Furnished single room PH 3 Freiburgstrasse 34 (old: 44c), 3010 Bern With washbasin, with fridge, with internet, Common shower/toilet/kitchen on the floor Final cleaning	CHF 650.00 (CHF 800.00) CHF 150.00 (CHF 150.00)
☐	Furnished single room PH 7 Hochbühlweg 4, 3012 Bern With washbasin, with fridge, with internet, common shower/toilet/kitchen on the floor Final cleaning	CHF 650.00 (CHF 800.00) CHF 150.00 (CHF 150.00)
☐	Furnished single room PH 8 Niesenweg 10, 3012 Bern With shower/toilet, with fridge, with internet, common kitchen in the basement Final cleaning	CHF 750.00 (CHF 930.00) CHF 150.00 (CHF 150.00)
☐	Furnished double room PH 8 Niesenweg 10, 3012 Bern With shower/toilet/kitchen, with internet Final cleaning	CHF 960.00 (CHF 1'120.00) CHF 200.00 (CHF 200.00)
☐	Furnished single room PH 9 Niesenweg 6, 3012 Bern With fridge, with internet, common shower/toilet/kitchen on the floor Final cleaning	CHF 650.00 (CHF 800.00) CHF 150.00 (CHF 150.00)
☐	Furnished double room PH 9 Niesenweg 6, 3012 Bern With fridge, with internet, common shower/toilet/kitchen on the floor Final cleaning	CHF 870.00 (CHF 1'030.00) CHF 200.00 (CHF 200.00)

Place, Date:	Place, Date:

Signature: ______________________________	Signature: _____________________________

1st Person	2nd Person