Chevinha 2011-2026

Housing Application Form Forularz podaniowy spoldzielni mieszkaniowej Please return this form to Chevin Housing Association Ltd Harrison Street Wakefield WF1 1PS Tel 0845 270 1088 E-mail enquiries chevinha.co. uk www. chevinha*co. uk Office use only Name App Date Ref No Banding Please fill in this form to apply to be on the Chevin Housing waiting list If you need any help completing this form please ring us on 0845 270 1088. Instructions on how to fill in the form Please write in BLOCK CAPITALS using black ink. If a section does not apply to you please leave it blank. Please send this form back straight away we can only start the registration process once we have received your form* If you have not received a Property List with this application form please contact us. Please complete all the questions that are applicable to you. We will contact you if your form is not fully completed however this may delay your registration* You will need to provide supporting evidence to supplement your application where requested* We will treat all information you supply in confidence. Chevin s lettings policy We want to let our homes in such a way that people have peace and security in their home and have a choice about where they live. However our core principles are to help those who are in housing need* We also want to treat all applicants fairly and with professionalism* However we do not allow everyone onto our waiting lists. Anyone who has a criminal conviction or known activity for crimes relating to anti-social behaviour will not automatically qualify for the list. If someone applies in this category we look carefully at each case individually and make a decision* These decisions are based on our exclusion policy and you can request a copy of this if you wish. 1. Where would you like to live Please choose only from the property list provided Please tick here if you have a local connection to the area you choose. Examples of a connection are to be near your work your children s school medical facilities or to give or receive support. You must give details including names and addresses of your connection* Chosen scheme Please list here 1a* How many bedrooms do you need 1 bed 2 bed 3 bed 4 bed 5 bed Bungalow Maisonette Bedsit 2nd floor 3rd floor 4th floor 1b. What property type do you need House Flat 1c* What floor level do you need Ground floor 1st floor Above 5th floor Any floor 1d. Are you or any joint applicant a Chevin Housing member of staff or related to a Chevin Housing member of staff or board member Yes No If yes please give details 2. Why do you want to move Please tick as many boxes as appropriate Homeless in next 28 days Temporary accommodation Urgent medical need Less urgent medical need Suffering domestic violence Harassment Received notice to leave after 28 days Sleeping rough Urgent need to receive or give support Less urgent need to receive or give support Relationship breakdown Family split Living in unfit property Home in poor condition Overcrowding Financial problems Want to live in the area Urgent transfer Less urgent transfer All fields marked with will require you to provide supporting evidence when you receive a home visit from us.