Housing Enquiry

This form collects some details about your housing requirements. We will tell you whether we are able to help you within a reasonable time. If we are unable to assist you in the near future we will keep your details on record to guide future development decisions and may contact you then. Please fill in all the details you can.

Completion of this form does not mean you have been accepted on to our waiting list.

About You

Title(Required)

First Name(Required)

Last Name(Required)

Age(Required)

What is your age?

If you are under the age of 55 we may not be able to allocate a home to you until you reach the age of 55.

Telephone Number

Address(Required)

Street Address Address Line 2 Town/City Postcode Country

Tell us why you want to leave your current home(Required)

Your Family
Who is moving with you?

We will need to know details of all the other who will move with you.

How many people are moving with you(Required)

(Not including yourself)

Make sure you enter all the details about the people you are moving with. If you do not enter those details they will not be considered when deciding how many bedrooms you will need.

Person 1

Person 1 - Age(Required)

Please enter a number from 0 to 120.

What is their age?

Person 1 - Relationship(Required)

What is their relationship to you?

Please state(Required)

Where do you want to live?

Please choose ALL the schemes you want to apply for.(Required)

Antilles Court Longsight

Birch Court Longsight

Bougainvillea Garden Longsight

Daisy Bank Court Victoria Park (Rusholme)

Sycamore Court Miles Platting

From the areas you have chosen which would be your first choice?(Required)

Where do you wish to live where we do not have properties.(Required)

Click on the plus (+) to add more places.

How did you hear about Arawak Walton

Hidden

Please state

Equality & Diversity
For research purposes we would like to know about our customers. You do not need to answer any of the following questions for us to consider your application.

What is your ethnic origin?

Please choose a category which best describes your household.

Hidden

Please state

Are you or any member of your family registered as disabled?

Yes

Are you

Employed

Retired

Unemployed

Student

If you are employed what is your household's combined yearly salary (before tax)?

Do you receive any benefits?

Yes

What is your sexuality?

Straight/Heterosexual

Gay Man

Lesbian/Gay Woman

Bisexual

Prefer not to say

In order to deal with your enquiry we need to collect relevant personal details. We comply with the General Data Protection Regulations 2016 when dealing with this data and the information you have given will be processed in accordance with the law. Please note we may share personal data with other organisations where appropriate in line with our Fair Processing Notice. Please tick the box below if you consent to this notice.

Fair Processing Notice(Required)

I have read the fair processing notice and consent to this notice

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Name

This field is for validation purposes and should be left unchanged.

Survey	Date sent out	Reply cut off date
1 Services	March 2017	17th April 2018