Contour Application for Housing.qxd:Layout 1 - Contour Homes

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Why do you want to move? Please tick ALL the boxes that apply to you I need to move because: I am homeless (We will require proof from the Local Authority) I am overcrowded I want to move to a smaller property Relationship breakdown My home is in bad condition What repairs are needed? I have been asked to leave A formal notice been served Please give details My child or a partner live in separate accommodation Please give their address: Postcode I cannot afford the rent/mortgage I cannot manage the stairs What floor do you live on? Is there a lift? I find it difficult to heat/maintain my home I would like to move to accommodation for people over 50 I am having problems with my neighbours I need to move closer to provide or be given support. Where do they live? I want a home of my own I have another reason to move: Postcode 4
What links do you have with the area you have chosen? I/We work in the area. 1st Please give details: 2nd I/We have been offered a job in the area. 1st Please give details: 2nd I am studying/receive training in the area. 1st Please give details: 2nd I have family living in the area. 1st Please give details: 2nd I have previously lived in the area for 1st years 2nd years. Please give the address: 1st 2nd My children attend school in the area. Please give details: I carry out voluntary work (or similar) in the area. Please give details: Do you/2nd applicant suffer from any health problems? Yes No Please give details: 1st 2nd 5
Page 1 and 2: Application for Housing Please retu
Page 3: Equal Opportunity You Faith Joint A
Page 7 and 8: Employment/Education Details Curren
Page 9 and 10: Employment/Education Details Curren
Page 11 and 12: Relationship to staff or committee

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