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Please complete this online Housing Application Form providing as much detail as possible. 

A Housing Support Officer (HSO) will look at your application form and decide whether our service could fit your needs.  If they think it could and we have a property available, then we will invite you for an appointment which may be held face to face *, over the phone or via a video call.


You will be asked a number of questions to check that the accommodation and support is suitable for you and you will have an opportunity to ask us questions too.  We may ask if it’s ok to speak to the landlord where you live now. You can bring someone with you, maybe someone from where you are staying now


*Please note - Due to the current Covid crisis we will be conducting all appointments online or over the telephone

ONE CIC - Housing Application Form

1. Who is filling in this form?

Please ensure you fill out section 5 if someone is filling out the from for you or helping you

2. Your personal contact details:

3. Homelessness

Are you homeless or at risk of homelessness or living in unsuitable accommodation at the moment?

4. What support do you need?

Which areas do you think you need support to enable you to keep your tenancy, keep safe and lead the life you want?

Please explain why you need support in these areas?

Do you have any medical conditions or disabilities you’d like to let us know about?

5. Optional: Supporting organisation

If you are an organisation or relative supporting this application, please complete the following section

Please tell us in what capacity and for how long you have known the applicant?

Please tell us what you think the applicant’s housing and support needs are:

Click and hold to draw your signature in this box

6. Accommodation

Please check what accommodation we have in your area.

Please tick any or all boxes - which type of accommodation would be most suitable:

Please list any accessibility requirements:

See housing and support guide

We will need a separate form for anyone over 18

7. Safety

What do you need to keep yourself and those around you safe?

8. Affordability

This is to help work out if you can afford our accommodation.

Are you receiving benefits?

Please list when you started receiving each benefit? How much do you receive for each per week?

See housing and support guide

9. Accessibility

Please provide your signature below to say that you agree the information in this document is true and accurate:

Click and hold to draw your signature in this box

Thank you for your application.

We will be in touch with you shortly.

An error occurred. Try again later

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