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Applicant Details | South Lakes Housing

Applicant Details

Please complete the information below. This will be used to create your customer profile and to ensure that we are aware of your details and requirements when we contact you in future.

Application Completed By:

If you are completing this form on behalf of the applicant, please provide the following details;

Name

Contact Details

Relation/Connection to Applicant

By completing this section, I agree to allow South Lakes Housing to record my details further to the terms of the Privacy
Policy.

Overview

Number of Applicants

Number of other people in the household

 
  • Applicant 1

    Status *

    Full Name (Applicant one) *

    Gender *

    DOB *

    Mobile Number

    Landline

    Email Address *

    Contact Preference *

    Disabilities *

    NoneASD/AspergersBlind or Partially SightedDeaf or Hard of HearingHoarding TendanciesMental Health Difficulties Other Disability/Medical ConditionSpecific Learning DifficultyUnseen Disability (e.g. Epilepsy)Wheelchair or Mobility Difficulties

    Ethnicity *

    Nationality *

    National Insurance Num. *

    Employment Status *

    Is anyone in the household pregnant? *

    Any Sight, Hearing or Language Needs? *

    NoInterpreter NeededLarge FontBrailleBritish Sign Language User

    Has anyone in the household served in the Armed Services? *

    If anyone has served as a regular, did they leave in the last 5 years?

    Has anyone in the household been seriously injured as a direct result of their time in the armed services?

    Does anyone in the household use specialist equipment such as a Mobility Scooter, Oxygen, or anything else? Please state all items *

    What is the main reason for you leaving your last settled home? *

    Does anyone in the household require specialist access? *

    NoDisability RequirementsFull Wheelchair AccessWheelchair Access to Essential RoomLevel Access HousingOther Disability Requirements

    Is anyone in the household related to a SLH staff member? *

     

  • Applicant 2

    Status *

    Full Name (Applicant Two) *

    Gender *

    DOB *

    Mobile Number

    Landline *

    Email Address *

    Contact Preference *

    Disabilities *

    NoneASD/AspergersBlind or Partially SightedDeaf or Hard of HearingHoarding TendanciesMental Health Difficulties Other Disability/Medical ConditionSpecific Learning DifficultyUnseen Disability (e.g. Epilepsy)Wheelchair or Mobility Difficulties

    Ethnicity *

    Nationality *

    National Insurance Num. *

    Employment Status *

    Is anyone in the household pregnant?

    Any Sight, Hearing or Language Needs?

    NoInterpreter NeededLarge FontBrailleBritish Sign Language User

    Has anyone in the household served in the Armed Services? *

    If anyone has served as a regular, did they leave in the last 5 years?

    Has anyone in the household been seriously injured as a direct result of their time in the armed services?

    Does anyone in the household use specialist equipment such as a Mobility Scooter, Oxygen, or anything else? Please state all items *

    What is the main reason for you leaving your last settled home? *

    Does anyone in the household require specialist access? *

    NoDisability RequirementsFull Wheelchair AccessWheelchair Access to Essential RoomLevel Access HousingOther Disability Requirements

    Is anyone in the household related to a SLH staff member? *

     

  • Household Member 1

    Relationship to Applicant 1

    Status

    Full Name

    Gender

    DOB

    Employment Status

     

  • Household Member 2

    Relationship to Applicant 1

    Status

    Full Name

    Gender

    DOB

    Employment Status

     

  • Household Member 3

    Relationship to Applicant 1

    Status

    Full Name

    Gender

    DOB

    Employment Status

     

  • Household Member 4

    Relationship to Applicant 1

    Status

    Full Name

    Gender

    DOB

    Employment Status

     

  • Household Member 5

    Relationship to Applicant 1

    Status

    Full Name

    Gender

    DOB

    Employment Status

     

  • Household Member 6

    Relationship to Applicant 1

    Status

    Full Name

    Gender

    DOB

    Employment Status