THIS APPLICATION FOR A TENANCY WILL BE CONSIDERED TO TENANTS 55 YEARS AND ABOVE
Surname*
First Name(s)*
Email*
Date of Birth*
Telephone
Mobile
Address
Postcode
How long have you lived at the above address?
Years
Months
National Insurance Number
Marital Staus
Occupation
Name & Address of Employer
Net Pay £ WeeklyMonthly
Details of Pension / Benefit £ WeeklyMonthly
Other Income e.g. maintenance payments £ WeeklyMonthly
Surname
First Name(s)
Date of Birth
Relationship to You
Address (if different from above)
Status OwnerTenantLodger
Dates
Reason for Leaving
Current Property Type TerracedSemi-DetachedDetachedFlat
Are you? OwnerTenantLodger
If rented, what is your current Rent? £
If owned what is the approx. Value? £
If you are a Private Tenant, please provide the details of the person or company that you pay your rent to now
Name
Email
Any Special Circumstance and reason for your application (e.g., Medical Issues, Personal Safety Concerns, for example, would stairs be a problem)
Do you have a Preferred Scheme? Stalybridge (Castle Hall Close)Hyde (The Woodlands)No Preference
Are you related to any employees of W C Dawson &anp; Son Limited or Longdendale Housing Society Board Members? YesNo
If so, Who?
How did you hear about this application?
Do you know any of the Current Tenants? YesNo
Do you own a pet? YesNo
If so, what kind of pet?
Contact No.
BY SUBMITTING THIS FORM, YOU ARE GIVING LONGDENDALE HOUSING SOCIETY PERMISSION TO CONTACT OTHER AGENCIES WITH REGARD TO YOUR APPLICATION
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