Housing Application Form

It is really important that you provide as much information as possible to avoid delays in processing your application.

We want to know more about the reasons you want to move, so that we can make sure that we can meet your needs.

This section will help us to understand your needs and lifestyle. It is helpful for us to have an overview of your current living circumstances.

We would like to know about your current care needs and any support you receive. It helps us to have an understanding of your care and support needs if you were to move to JBD accommodation

We want to know about the things you need that support you to manage to live independently and what you might need if you were living in JBD accommodation

We want to know about your physical and/or visual limitations, if any; if you are able to move around independently

This section will help us to understand more about your current accommodation, how you manage and your limitations within it.

Please leave sections blank if the questions do not apply to you

It is important for us to be aware of any medical related conditions and to keep a record as we progress with your application

We require a copy of your Medical Summary which is a brief document obtainable from your GP. This is currently not subject to any charges. You must contact your GP to prevent your application being delayed. If this is a joint application, please provide copies of both of your Medical Summaries.

It is important to us to have an awareness of your emotional vulnerabilities and wellbeing as we progress with your application

How much rent you would have to pay depends on your income and capital. You may be asked to verify this information and sign a financial declaration.

Please note that in the event of a tenancy being offered and taken up, where it is discovered that a tenant has deliberately given false information in their application for a tenancy, a County Court can make an order for possession of the dwelling on behalf of the Landlord under schedule 2 of the Housing Act 1985 and no alternative accommodation need be provided. The information contained on this form could be required for calculation of Housing Benefit or Universal Credit, or to assess if there has been a deprivation of assets. We agree for this information to be made available to the relevant Local Authority or Government departments. If we are successful in our application we understand that Jewish Blind & Disabled may ask for evidence of my finances and for additional medical information.