Birmingham Self-Build Register About you Are you the applicant, or are you acting on behalf of the applicant(s)? Required ApplicantActing on behalf of the applicant(s) Are you an individual, or are you an association or group of individuals? Required IndividualAssociation or group of individuals Title Please select ... Miss Mr Mrs Ms Mx Other First names Required Help: If you are applying on behalf of an association or group, please tell us the lead contact person Last name Required Email address Required Phone 1 Phone 2 House / Flat number or name Required Road Required Area Required Town / city Postcode Required Preferred method of contact EmailLetterPhone 1Phone 2 Are you aged 18 or over? Required YesNo Date of birth Required Help: This is required by legislation Are you a British citizen, a national of an EEA State other than the United Kingdom, or a national of Switzerland? Required YesNo Nationality Required Are you seeking to acquire a serviced plot of land in Birmingham to build a house as your sole or main residence? Required YesNo Have you lived in Birmingham for the past 2 years? Required YesNo Do you currently have part-time or full time work in Birmingham? Required YesNo Do you have any immediate family members who reside in Birmingham? Required YesNo Are you or your spouse in the regular Armed Forces of the Crown, or did your or your spouse cease service within the last five years? Required YesNo I confirm that I (If applicable) and all members applying to the self and custom build register meet at least one of the conditions of the local connection. I (If applicable) and all members applying to the self and custom build register agree to supply evidence to demonstrate my/their/our local connection when requested by Birmingham City Council. If you agree to the condition set out above please select yes, if you do not agree to the condition select no Required YesNo Next By submitting this form you agree to Birmingham City Council processing your data in accordance with our terms and conditions and privacy statement.