Application Test

Please answer all the questions IN CAPITALS in the sections that apply to you. If you are unsure how to fill in the form, please telephone 01790 754219 and speak to Customer Services.

Application Form

1. Your Details

2. Ethnic Origin

3. Why are you applying for a new home?

4. Income details

5. About your present home

6. Your family or household

6.1 Your family or household > People who currently live in the household or who you would like to live with you

6.2 Your family or household > Address of people who want to be rehoused with you

6.3 Your family or household > Details of arrangements for a child/children whose main home is elsewhere

7. About your medical or social needs

8. Where have you lived in the last 5 years?

9. About the home you would like

* A local connection is; If you have immediate family living in the village or within a five mile radius, you are living there now, have previously lived there or have employment in the village or within a five mile radius.

Local Connection

Please give details of the immediate family or employment that you have in the village that you are requesting to be re-housed in;

10. Convictions

11. Actions for anti social behaviour

12. Rent arrears

13. Other information

14. Declaration

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