Housing Registration Form

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1 Registering with us Housing Registration Form GHA and Cube are both social landlords and are part of Wheatley Group, Scotland s leading housing group. We work together to provide a range of services in our local areas. We run an advertised letting service based on housing need. People looking for a home to rent can see all the homes available for let through both landlords and note an interest in any which match their needs. But first you have to register before you can start noting an interest in our homes. Please fill out this form as part of your first step to finding a home with us. Once you have completed the form, send it back to us by: posting it to the Housing Access Team, Wheatley House, 25 Cochrane Street, G1 1HL handing it into a local housing office dropping in to our shop at 173 Trongate. If you re online, please click the submit button at the end of the form or it back to us at: or Once you have registered we will send you your registration number, applicant group and PIN. You need these details to note an interest in a home. If you need help to fill in the form or want it in another language, large print or on audio format, just get in touch. We re here to help. Our webpage: or or Call us free from a landline on: If phoning from a mobile it may be cheaper to call:

2 Section 1 Your details Applicant Joint Applicant Title Mr Mrs Miss Ms Mr Mrs Miss Ms First name Surname Date of birth dd / mm / yy dd / mm / yy Gender Male Female Male Female N.I. number Address Postcode Telephone No. Mobile No. address Contact address (if different from above) Helpful hints The notes on the right hand side of each page will help guide you through the completion of this form. If you do not have an N.I. number, can you confirm that you have access to public funds in the UK (e.g. welfare benefits)? (This will not exclude you from our housing list, but will allow us to have a discussion with you on affordability of any tenancy) Please supply contact details of someone we could contact in an emergency Section 2 Application details Why are you applying for housing? (Please note your reasons, for example property too large, too small, medical condition, move to another area) It will help us to assess your application and to ensure that you have the best possible opportunity to access a home if you give us a brief description of why you are applying for a home. Page 2

3 Section 3 Other people to be re-housed with you? Name everyone who is going to be living in the house Relationship to you Gender (male/ female) Please tick Is this person currently living with you? Please tick Date of birth m f Yes No dd / mm / yy National insurance number (only for people 16 or over): m f Yes No dd / mm / yy National insurance number (only for people 16 or over): m f Yes No dd / mm / yy National insurance number (only for people 16 or over): m f Yes No dd / mm / yy National insurance number (only for people 16 or over): m f Yes No dd / mm / yy National insurance number (only for people 16 or over): m f Yes No dd / mm / yy National insurance number (only for people 16 or over): In order for us to assess the size and type of home that best meets your needs, it is important that you tell us of all the people who will be housed with you, and whether or not they are living with you at present. If they are not living with you now, please let us know why not and where they are living now. Name Current address Reason for separation If anyone on your application is pregnant what is their name and when is the baby due? Name Date Is anybody in your household on the Sex Offenders Register? If yes, please tick this box This will not adversely affect how your application is assessed but will allow us to work with you and the Sex Offenders Liaison Officer to identify the most appropriate offer of housing. Page 3

4 Section 4 Address history Please list all addresses you have lived at for the last three years we may carry out checks and ask for references. Applicant Address Full name (if different to your current name) Date from Date to Name and address of landlord, or note if owner/ occupied and reason for leaving Please list all addresses you have lived at for the last three years we may carry out checks and ask for references. Joint Applicant Address Full name (if different to your current name) Date from Date to Name and address of landlord, or note if owner/ occupied and reason for leaving Page 4

5 Section 5 Previous history Has anyone ever taken action against you, anyone else in your household, or anyone on your application for anti-social behaviour? If yes please give full name of person(s): Yes Court action taken? Yes No No This information will help us to work with you to assess any support you need to make sure you have every opportunity to successfully manage your tenancy with us. Anti-Social Behaviour Order (ASBO) Less formal action taken e.g. Verbal/Written Warning Do you or any joint applicant have current or former tenant rent arrears with Cube or GHA or any other landlord? If yes name of the landlord: Yes No Have you made arrangements to clear Yes No your debt? Are you maintaining the arrangement? Yes No Section 6 Your circumstances A. Which of the following describes your current circumstances? Please tick one Cube tenant GHA tenant In HM Forces Other housing association tenant In supported accommodation Council tenant (outside Glasgow) Hospital Prison Residential care Tenant of private landlord Homeless Staying with family / friends Lodger Owner No fixed address In housing tied to employment Other (if other please state below) This information will help us to understand your current living circumstances and how this affects your application for a new home. Page 5

6 Section 6 Your circumstances B. What type of home do you currently live in? Please tick one Tenement / flat Multi-storey House / semi detached / terrace Four in a block upper flat Four in a block lower flat Deck access Hostel Hospital Residential Prison Sheltered housing Supported accommodation Caravan or similar Bedsit / studio flat No fixed address Other (if other please state below) C. How many bedrooms are in the home you currently live in? How many bedrooms do the people included in this application have exclusive use of? How many people are living at your current address? D. Has your home been assessed by local authority as below tolerable standard? Yes No If answered yes, please provide a copy of the Environmental Health assessment Section 7 Your needs A. Do you or anyone who is going to be housed with you have any care / support / medical needs that would be helped by a move to another home? If yes, please complete a medical assessment form. Medical assessment forms can be obtained from your local housing office, or by contacting us on , or via our websites at or If you currently receive support from an organisation i.e. Social Services, health agency, voluntary organisation, please provide details below including name of organisation and name / contact number of your worker Yes No This information will give us as clear a picture as possible of any medical or support needs that you have, and allow us to ensure that you have access to the most appropriate properties that meet your needs. Page 6

7 Section 7 Your needs B. All our vacant properties will be advertised via the internet and on weekly publications available from local offices or mailed to you. Would you require help with expressing an interest in these advertisements? If yes, what type of help do you think you need? Yes No C. Do you require sheltered housing? Yes No If yes, please complete additional sheltered housing application form. Sheltered Housing assessment forms can be obtained from your local housing office, or by contacting us on , or via or D. Do you need to move to be near family or Yes No relatives to provide or receive support? If yes, please provide details including which area you require to move to: E. Do you or a family member need to move to Yes No be near a place of education? If yes, please provide details including which area you require to move to: F. Do you require to be re-housed near your Yes No place of employment or a place where you do voluntary work for 16 hours per week or more? If yes, please provide details including which area you require to move to: Page 7

8 Section 8 Relevant details Please note below any other details that you feel may be relevant to your application: If you feel that there is any further information that may be important for us to consider when assessing your application, please tell us about it here. Each year, GHA holds local Community Housing Plan Forums to discuss and suggest letting ratios for the local Community Housing Plan Area for the following year. Would you be interested in participating in one of the local forums? Yes No Would you be interested in finding out how you can get more involved in Cube or GHA and help shape our services? Yes No Section 9 Further information In the last 12 months have you or anyone related to you been an employee of GHA or Cube or a Committee member of GHA or Cube? If yes please give details of relationship: Name Address Yes No This information is required for our internal administration purposes and will not affect your application in any way. Relationship Page 8

9 Section 10 Declaration I / We hereby declare that the information given on this application form is, to the best of my / our knowledge and belief, accurate and truthful. I / We understand that if it is found that I / we have provided false or misleading information to the Association; my / our application will be cancelled. Furthermore, I / we understand that participating landlords reserve the right to take legal action for the repossession of any tenancy granted on the basis of deliberately providing false information. In addition I / we understand that in circumstances of threatening behaviour or verbal or physical abuse aimed towards staff or committee members, participating landlords reserve the right to withdraw an offer of housing or suspend my / our application. I / We authorise GHA/Cube Housing Association to obtain information on any tenancy I / we have held and to take up references considered neccessary and relevant to this application. I / We understand that my / our home will be at risk if I / we do not keep up with rent payments. I understand that any false or misleading information, withholding information that is material to the application now and at any time, may result in my application being cancelled, any offer of tenancy being withdrawn or I may lose any tenancy I am granted. Applicant Signed dd mm yy If you re applying online you can just type your name above. Joint Applicant Signed dd mm yy If you re applying online you can just type your name above. If you become a Cube or GHA tenant you will be asked to pay four weeks rent in advance. If you receive, or are entitled to receive, housing benefit this will be taken into account. If you are on Housing Benefit and your home is considered to have more bedrooms than you need under the UK Government s guidelines, you will be required to pay a proportion of the rent yourself. Your home will be at risk if you do not keep up with your rent payments. Cube and GHA tenants will automatically be registered for Home-swapper (Mutual exchange scheme) should you wish to opt out of the scheme, please tick this box Data Protection Cube and GHA are registered under the Data Protection Act They are under an obligation to properly manage public funds. Accordingly information that you have provided on this form may be used to prevent and detect fraud and may also be shared for the same purpose with public bodies or other organisations which handle public funds. Page 9 Although vacant properties are advertised every week at If you re unable to access the internet do you wish to receive a weekly copy of our advertised properties by post? Yes No Now you have completed the form you can send it back to us by ing it to or if you re not online, you can send it to us: by post at 25 Cochrane Street, Glasgow, G1 1HL hand it in to your local housing office in person at our shop at 173 Trongate Thank you for applying. We will be in touch shortly with your registration details.

10 Official use only Local Office Applicant name Address Registration number Housing debt check carried out: Yes No Housing debt outstanding: Yes No Application to be suspended? Yes No Income and Expenditure form completed: Yes No Community and Social (Group 4) priority awarded? Yes No Under assessment Community Letting Area approved for CSS award: Area: Sheltered Housing (Group 7) priority awarded? Yes No Under assessment Medical priority awarded? Yes No Under assessment If yes, was it Group 3 or Group 5 GHA / Cube tenants only Group 6 awarded Yes No If noted as homeless, referral made to CCT? Yes No If yes, date referred: Scanned to Allocations Team Signed dd mm yy Official use only Group Allocation Team Date of registration Date form loaded dd mm yy dd mm yy Page 10

11 Your next steps Thank you for registering with us We will be in touch shortly with your registration details. As soon as you receive these details you can start looking for a home and note an interest in your preferred properties. Register with us Once you have registered you ll be given a Registration Number, Applicant Group and PIN. You need these details to note an interest in a property. Looking for a home Available homes are posted on our website each week. If you want to note an interest you will need your Registration Number and PIN. You can search by visiting Note an interest You need to note an interest before the weekly deadline of 8pm on a Monday. You can note an interest in up to two properties a week for each landlord. Your offer If your application has been successful we will contact you as soon as possible after the closing date. If your application has not been successful you can continue to note an interest in new properties each week. We advertise properties: on Home Finder at at your local housing office at our shop at 173 Trongate in Glasgow city centre in our weekly Home Finder leaflet which can be posted to you on request. Page 11

12 Would you like more information? Our webpage: or or Call us free from a landline on: If phoning from a mobile it may be cheaper to call: WG-HRF/JUL13

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