Switch to Wolds & Coast Domiciliary Agency
Please make sure that in the box below you give all of the following:
In order to make sure we are providing a housing service which does not discriminate on the grounds of colour or of national or ethnic origin, please help us by selecting the boxes which you feel best describe your household as a whole. This information will be totally confidential and will not affect your application in any way.
Please list all the addresses where you (and joint applicant) have ever lived in the past 3 years. Start with your present address first. Also list any East Yorkshire Housing Association Limited's property you have ever lived in.
Which of the following best describes where you live?
If yes, please describe in what way it has been adapted:
Please tick any of the following if they are either lacking or if you have to share them with people who will not be moving with you.
An inside WC
A hot water supply
Please tick any of the following problems that affect your home severely:
People apply to us for re-housing for a number of reasons and we have tried to list all these reasons below. Do not worry if most of the reasons do not apply to your situation - just tick the box or boxes which best describe why you are applying for re-housing. Then underline the single most important reason.
Sometimes, people have very personal reasons for wanting to be re-housed. Below are some of these reasons, please tick any that apply to you:
Only complete this section if you, or a member of your household who wishes to be re-housed with you, have a medical condition, illness or disability.
The information which you supply on this section will be used to measure your housing needs on medical grounds.
Do you, or any member of your household have any of the following:-
For more information call 0126 240 0789 or contact us
East Yorkshire Housing Association Grove Centre 78 Bessingby Road, Bridlington, East Riding of Yorkshire YO16 4SH, England
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