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| Is anyone on the application form pregnant? |
| Name |
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| Date Baby Due |
(Please provide proof of pregnancy showing date baby due) |
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Update your medical needs |
Do you think that you require
ground floor accommodation? |
Yes
No |
If yes, please say why you need
ground floor (eg medical reasons) |
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| Would lift access be adequate? |
Yes
No |
| Do you require wheelchair access? |
Yes
No |
| Do you require other Aids or Adaptations? |
Yes
No |
| If yes please list aids or adaptations |
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| Please indicate if you would like information on |
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Housing Associations in Stafford Borough |
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Shared Ownership Schemes |
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Homebuy Schemes |
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Private Rented Accommodation |
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Hostels |
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| Stafford and Rural Homes (SARH) have a Mutual Exchange List which is on public display at The Rurals for those tenants wishing to find an exchange between other SARH or RSL (housing association tenants) and Council Tenants |
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I am interested in being registered on the Mutual Exchange List (Please tick if interested)
(Please note that this will involve having your details on public display in SARH offices and on the website and a form will be sent to you for completion.)
The list is available at: Head Office Location: 1 Parker Court, Dyson Way, Staffordshire Technology Park, Beaconside, Stafford, ST18 0WP, Stafford Housing Advice Shop: 56 Greyfriars, Stafford, ST16 2RY, Stone Housing Advice Shop: 3 Crown Courtyard, Stone, ST15 8UY |
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REFERENCES |
PROVIDE THEM NOW TO PREVENT DELAYS |
You are required to supply two references, you can download references from the Homesfirst website, www.sarh.co.uk. One should be from your current or previous landlord if this is applicable to your circumstances. Other suggestions for references could be from your employer (present or past) or from a professional person who knows you. See Glossary of Terms for further information on obtaining references on the Homesfirst web site.
If you do not provide two suitable references within 28 days your application will be cancelled. |
| WE DO NOT ACCEPT REFERENCES FROM FRIENDS OR FAMILY MEMBERS |
Please ensure you complete all parts of this section in full otherwise we will not be able to process your information
Disclosure of Information
I/We agree that SARH will keep our personal information for use in the performance of any of its services, and agree that disclosure of relevant personal information can be made to other organisations working with SARH to deliver services or provide housing.
- I/We understand that by giving a false statement and withholding information it is an offence (Section 171 of the Housing Act 1996) and if found guilty of this offence I/We may be liable for a fine of up to £5,000.
- I/We confirm that the information given in this application form is correct to the best of my/our knowledge.
- I/We agree to notify SARH of any changes in the details given in this form.
- I understand that action can, and may be taken against me/us if I/we fail to provide up to date information regarding my/our circumstances.
By submitting this applicant you are agree that my personal information can be displayed on SARH Website and at its reception areas in order to improve my chances of finding a mutual exchange.
By submitting this form you certify that the information given on this form is correct, and you understand that, should it prove that a false statement has been made action may be taken against you.
Please ensure that you have provided proof, where required. All proofs must be dated within the last 4 weeks.
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Please complete the questions below before you submit the form |
What type of property are you looking for? (Please tick)
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House |
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Bungalow |
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Flat/maisonette |
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Studio Apartment |
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How many bedrooms do you require? (Please tick)
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StudioApartment |
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1 bedroom |
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2 bedroom |
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3 bedroom |
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4 bedroom |
For a guide on eligibility see below.
The size of accommodation a household will be eligible for will be assessed form the information you submit on your application
- 2 and 3 bedroom houses, preference will be given to households with children under the age of 18.
- 4 bedroom houses, preference will be given to households who will fully utilise all the rooms, for example a household with 4 or more children.
- Bedroom requirements - if there is a severe shortage of certain property types in the area, priority will be given to households who need all the bedrooms in a property. It is considered that the following require their own bedroom:
- A couple (including husband and wife or partners of the same or opposite sex)
- Each child over 9 years of age of different sexes.
- Lodgers
- Sleeping carers
For further details on property size and eligibly criteria please refer to the Homesfirst Choice Based Letting Policy |
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| Are you interested in buying a home on a low-cost home ownership basis? |
Yes
No |
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| We are keen to ensure that our services are accessible. To help us monitor what is the preferred methods of bidding, please can you indicate which method you would use if you saw a property you were interested in? |
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The website |
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By telephone |
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In person (e.g. at one of our offices) |
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Please tick the box(es) below if you would use the following methods of placing a bid, if they were available.
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Automated telephone bidding |
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SMS Text messaging |
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| Is there any further information you feel that we should be providing? |
Yes
No |
| If yes please supply details |
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| Are you satisfied with the way we are dealing with your application? |
Yes
No |
| If no please supply details |
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Information to Applicants |
Applicants are able to:
- View information contained on our computer system
- Change information regarding areas of choice and circumstances
- Seek advice, guidance and information on re-housing options
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