Ymca Housing Application Form For Supported Housing
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8YMCA HOUSING APPLICATION FORM FOR SUPPORTED HOUSING
Office Use: Date Application Received
_____/_____/________
Information provided in this application will be treated as confidential and will not be
passed on to anyone outside of Fylde Coast YMCA without the applicant’s permission.
First Names
Surname
Also Known As
Date of Birth
Age [
]
Place of Birth
Gender
Female [
]
Male [
]
National Insurance Number
Contact Telephone Number
Language(s) spoken / preferred
Where would you like to live?
For consideration by more than one scheme please
st
nd
state 1
/2
choice as appropriate but send the form
to the your first choice:
George Williams House in Fleetwood
Harbour House in Lytham
Wyre YMCA Foyer in Fleetwood
Who, if anyone, needs to be housed with you? Please state names and ages.
Note this
only applies to George Williams House
Current Address including post code (if
Present Accommodation
Please tick which best describes your present
known)
accommodation
Renting from a Housing Association
Renting from private landlord
Living with family or friends
B&B or temporary accommodation
Prison or similar
Hostel
Homeless
Owner occupation
Children’s home / foster care
Other (please state)
Where did you hear about YMCA Housing
Time at current address:
Application/first interview - Application Form V3.1
Updated October 2010
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