Online Application
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Other Details
Please only answer the following questions if they are relevant to your household.
Please enter an address that you want us to use for correspondence, if this address is different to the address you are currently living at.
If you are living at the address stated on previous pages, go to the next question. If you are living at a temporary address that is different from the application address, please write it below:
(Please be advised that dogs are not allowed at our high rise or Independent Living properties)
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People in Household
This section is for the people who will be living with you at any new property that you move to.
If there is a person who is going to be a joint applicant (must be 16 years of age or older) then please complete the full details on the form below.
Person 2
Person 2 - Personal Details
MaleFemaleYesNoPerson 2 - Contact Details
Email AcceptableEmail Preferred󠅏Do Not Use Email -
People in Household (continued)
For each additional person who is part of the household who would be moving with you to a new home, please complete the following details.
Person 3
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Types of Property Requested
Please indicate which types of property you would consider if your application is successful.
Type of Property Description Selection Deck Access Flat Flat or maisonette having a continuous inset balcony at each level onto which the front door of each property on that level opens Main Door Accommodation that may be adjoined to other properties, such as a tenement building, but does not share a common front door Mini-Multi Storey Flat Flatted accommodation which rises seven stories high and is equipped with a lift (to the sixth floor). Maintained by a concierge service Multi Storey High Rise Flatted accommodation which can be as high as 19 floors and is serviced by two lifts. Family sized flats are a maximum of ten stories high. Maintained by a concierge service. Tenement Usually three story high blocks with dwellings of various sizes which share common areas, such as back courts with other residents. Tenement with Lift A tenement building which may be higher than three stories but is serviced by a lift. Common areas are shared with other dwellings. Tenement with Main Door A tenement which does not share a common door with the rest of the block, however may share other common areas. Terraced House Part of a row of dwellings which are connected by their side walls. Usually has a private garden. Wheelchair Adapted Flatted accommodation that is specially designed or has been adapted for wheelchair access. Amenity Accommodation which is accessible for people with mobility issues. People who are over 50 years of age are automatically considered for amenity housing. Independent Living Self-contained flats which are generally smaller and easy to manage, designed specifically for older people. Alarm system on site, communal laundry room, lounge, garden and guest flat available. Age restrictions apply. 1 Apt or Bedsit (single persons only) Studio style apartment with combined living room / bedroom, bath or shower room and kitchen area. If any member of your household has mobility issues and you require a property which has any special requirements, such as being on the ground floor etc, please submit medical evidence of this either through a Medical Self-Assessment Form or by submitting a evidence from a medical professional.
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I hereby declare that the information given on this form is, to the best of my knowledge and belief, accurate and truthful.
In addition, I understand that my application may be suspended, and any offers of housing may be withdrawn if I, any joint applicants, or any third parties acting on my behalf, subject any member of COMPANY NAME HERE staff or committee members to physical or verbal abuse.
I authorise COMPANY NAME HERE and my former landlords to share information on any tenancies I have held in the past by way of references considered necessary and relevant to this application. I also authorise my employers to provide necessary information that is required by COMPANY NAME HERE in support of my application.
I understand that providing false or misleading information, and withholding information that is material to the application now and at any time, may result in my application being cancelled or suspended and that any tenancies offered can be withdrawn. I also understand that tenancies granted on the basis of false or misleading information may lead to court action for repossession by the COMPANY NAME HERE.
I understand that the completion of this form does not bind COMPANY NAME HERE to any agreement or obligation to make an offer of housing accommodation available to the applicant(s).
I understand that if I should receive an offer of accommodation from COMPANY NAME HERE then I would be required to ensure that the I was in a position to pay the necessary deposit and understand that one month’s rent is payable in advance as per the Private Residential Tenancy Agreement.
Applicant Signature
Date
Joint Applicant Signature
Date