Application Form - Capital Housing Associates

Capital Housing Associates

Accomodations

1Tell us who you are

2About You

3Income Details

4Your Background

5Additional Information

Tell us who you are
Title*
First and Middle name*
Surname*
Are you male or female?*
Date of Birth (dd/mm/yyyy)*
House or flat, or room number and building name*
Address Line 2*
Address Line 3
Address Line 4
Postcode
Daytime telephone number (We will use this number to contact you if further information is needed.)
Mobile telephone number (We will use this number to contact you if further information is needed.)*
Your email address*
Do you have a partner?*
- Yes
- No
Marital status*

About You
What is your nationality?
What is your nationality, if 'other'?
If your nationality is not British, on what date did you last enter the UK (dd/mm/yyyy)?
Resident status in UK?*
Are there any children in your household?*
- Yes
- No
Please tell us how many children there are in your household?

Income Details
Income details
Do you (and your partner) have any bank accounts, building society accounts, post office accounts, capital, savings or investments (including property)?
- Yes
- No
Type of property required
Do you have any pets*
- Yes
- No

Your Background
Criminal Record*
- Yes
- No
Count Court Judgements*
- Yes
- No
Bad Credit*
- Yes
- No
History of Rent Arrears*
- Yes
- No
Please tell us if you have capital, savings or investments worth £6000.00 or more (£10000.00 if aged 60 or over)
- Yes
- No

Additional Information
Please tell us how you found out about us/ who referred you to us
Please tell us if we need talk to anyone else (eg. a relative, carer, social worker, friend etc.) about your application
- Yes
- No
Additional information/comments
Photo ID upload
Max. file size: 1 GB.
Document upload
Max. file size: 1 GB.
Consent
I agree to the privacy policy.
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