SHC Application Form
Answers marked with a * are compulsory
 
 
1. Your title (Mr, Mrs, Ms, Miss...) *
 
 
 
2. Your full name *
 
 
 
3. Your date of birth *
 
 
 
4. Your National Insurance Number *
 
 
 
5. Your address and postcode *
 
 
 
6. Your phone number *
 
 
 
7. Your e-mail address *
 
 
 
8. Are you registered with Homes for Bolton? *
 
 
 
9. Do you own or are you the tenant of any other property, not counting where you live now? *
 
 
 
10. If yes, please give details
 
 
 
11. Joint applicant's title (Mr, Mrs, Ms, Miss...)
 
 
 
12. Joint applicant's full name
 
 
 
13. Joint applicant's date of birth
 
 
 
14. Joint Applicant's National Insurance Number
 
 
 
15. Joint applicant's address and postcode
 
 
 
16. Joint applicant's phone number
 
 
 
17. Joint applicant's relationship to main applicant
 
 
 
18. Is the joint applicant registered with Homes for Bolton? *
 
 
 
19. Please give names and dates of birth of any other people (e.g. children) moving with you.
 
 
 
20. Do you have access to or shared custody of any children not named above? *
 
 
 
21. If yes, please give names and dates of birth below
 
 
 
22. Are you or is anyone you are moving with pregnant? *
 
 
 
23. Which of the following best describes your circumstances? *
      
 
 
 
24. Which of the following best describes the joint applicant's circumstances? *
      
 
 
 
25. What is your annual household income before tax? *
      
 
 
 
26. What is your current housing status? *
      
 
 
 
27. If renting, please give your landlord's name and address
 
 
 
28. How would you describe your current home? *
      
 
 
 
29. How many bedrooms does your current home have? *
 
 
 
30. How long have you lived at your current address? *
 
 
 
31. If less than five years, please give details of your other addresses over the last five years
 
 
 
32. Please tick the boxes that best describe why you need rehousing.  Proof will be required for those marked with a [P] *
       		 
 
 
33. Do you share all or part of your home with anyone who is not part of your household? *
 
 
 
34. If yes, please give details of what parts are shared, who with and whether they are relatives, friends or your landlord?
 
 
 
35. Do you have your own bathroom? *
 
 
 
36. Do you have an indoor toilet? *
 
 
 
37. Is your home in good condition? *
 
 
 
38. If your home is in need of repair or improvement, please give details
 
 
 
39. All tenants of Sensible Housing Co-op must become members. All members are expected to take an active part in the managing of the properties and sharing of the work involved. If you are accepted as a tenant you will be given training and you will learn more about how the co-op manages itself. Generally for most members this means attending monthly meetings. It is a big responsibility but it means that you can have real control over your own housing.The co-op is not an ordinary housing association.If you are not prepared to get involved in the co-op then co-operative housing is not for you. You can find more details about what we do here. In order for us to assess your suitability please state below why you would like to join a housing co-op and what skills, experience or time you could offer to us. *
 
 
 
40. Have you or has anyone in your household ever been evicted? *
 
 
 
41. Have you or has anyone in your household ever been convicted of a criminal offence? *
 
 
 
42. Are you or is anyone in your household related to a member of Sensible Housing Co-op *
 
 
 
43. If you answered yes to any of the last three questions, please give more detail here
 
 
 
44. Data Protection Act 1998: We use the information you give us on your housing application form in line with the Data Protection Act 1998. We may share the information with other landlords or ask for references from your previous landlords. It is important that the information you give us is accurate. We may use certain information on your form to check the accuracy with the Department for Work and Pensions, Police, Probation Service, Social Services, Bolton Council and other registered social landlords, private landlords or their agents.In completing this form you understand that in order to process your application we must share information you have provided with some or all of these agencies. All information which you have provided is processed in accordance with the Data Protection Act 1998.

Declaration: As far as I know the answers I have given on this form are true. I understand that I may lose any housing or tenancy if I have given false information. I will tell the co-op immediately if there is any change to the circumstances I have told you about on this form. I understand that by answering yes below, I am giving permission for you to contact any previous landlords and any relevant agencies to check the information I have given and I agree to them releasing to you any relevant information requested. *
 
 
 
 
 

Created with eSurveysPro.com Survey Software.