4 Other Information

Additional Information

Do you and everyone to be housed with you have the right to reside in the UK?

Yes

Have you, or anyone to be housed with you, been evicted for anti-social behaviour, or been subject of an Anti-Social Behaviour Order?

Yes

Do you, or anyone to be housed with you, have outstanding arrears, or any tenancy related debt e.g. rechargeable repairs which amounts to more then one month's rent and is related to a current or previous tenancy?

Yes

Have you or anyone on your application ever been convicted of a sexual or violent offence? (This information will be kept strictly confidential)

Yes

Is the client or anyone in the household required to register with the Police under the 'Sexual and Offence Act 2003'?

Yes

Do you require support to maintain a tenancy?

Yes

Are you an employee of or are you related to a staff or Committee member of any local social landlord?

Yes

Please Provide Additional Information

* Where did you hear about us?

Please select at least one of following options. If you select other, please provide additional details.

Sources

Landlord Referal

Our Website

Health Sector

Housing Organisation

Social Work

Occupational Therapist

Voluntary Organisation

Promotional Material or Leaflet

Other

Please Provide Additional Information